User interfaces for continuous glucose monitoring

ABSTRACT

The subject matter disclosed herein provides methods for presenting glucose level data. Glucose data for a patient may be received. A current glucose level and a rate of change of the current glucose level may be determined based on the received glucose data. A first interface may be displayed on a screen of a device. The first interface may include a unitary icon. The unitary icon may display the current glucose level and a visualization of the rate of change. Related apparatus, systems, techniques, and articles are also described.

INCORPORATION BY REFERENCE TO RELATED APPLICATIONS

Any and all priority claims identified in the Application Data Sheet, orany correction thereto, are hereby incorporated by reference under 37CFR 1.57. This application is a continuation of U.S. application Ser.No. 14/919,528, filed Oct. 21, 2015, which claims the benefit of U.S.Provisional Application No. 62/067,303, filed Oct. 22, 2014. Each of theaforementioned applications is incorporated by reference herein in itsentirety, and each is hereby expressly made a part of thisspecification.

FIELD

The present disclosure generally relates to the presentation of glucosedata on a computing device and, in particular, to the presentation of apatient's glucose data in a manner that provides the current status andprojected status at a glance.

BACKGROUND

Diabetes mellitus is a disorder in which the pancreas cannot createsufficient insulin. In a diabetic state, a person suffering from highblood sugar may experience an array of physiological side effectsassociated with the deterioration of small blood vessels. These sideeffects may include, for example, kidney failure, skin ulcers, bleedinginto the vitreous of the eye, and the like. A hypoglycemic reaction,such as a low blood sugar event, may be induced by an inadvertentoverdose of insulin, or after a normal dose of insulin orglucose-lowering agent. In a severe hypoglycemic reaction, there may bea high risk for headache, seizure, loss of consciousness, and coma.

A diabetic person may carry a self-monitoring blood glucose (SMBG)monitor which typically requires the user to prick his or her finger tomeasure his or her glucose levels. Given the inconvenience associatedwith traditional finger pricking methods, it is unlikely that a diabeticwill take a timely SMBG measurement and, consequently, may be unawarewhether his or her blood glucose value is indicative of a dangeroussituation.

Consequently, a variety of non-invasive, transdermal (e.g.,transcutaneous) and/or implantable electrochemical sensors are beingdeveloped for detecting and/or quantifying blood glucose values. Thesedevices generally transmit raw or minimally processed data forsubsequent analysis at a remote device. The remote device may have adisplay that presents information to a user hosting the sensor. In somesystems, a patient may check his or her glucose level on a hand heldcomputing device. There are challenges to presenting this informationdiscreetly and reliably.

SUMMARY

Methods and apparatus, including computer program products, are providedfor presenting glucose level data.

In one aspect, glucose data is received for a patient. A current glucoselevel and a rate of change of the current glucose level are determinedbased on the received glucose data. A first interface is displayed on ascreen of a device. The first interface includes a unitary icon. Theunitary icon displays the current glucose level and a visualization ofthe rate of change.

The above methods, apparatus, and computer program products may, in someimplementations, further include one or more of the following features.

The rate of change may be based on at least the current glucose leveland a second value. The second value may be representative of theglucose level of the patient at a second time preceding a timeassociated with the current glucose level.

The visualization of the rate of change may include one or more arrowsoriented in a first direction. The first direction may be representativeof whether the current glucose level is increasing, decreasing, orstable. The visualization of the rate of change may change by at leastvarying the first direction of the one or more arrows.

The one or more arrows oriented in the first direction may have a firstpointing direction of 0° when the rate of change is increasing, may havea second pointing direction of 180° when the rate of change isdecreasing, or may have a third pointing direction of 90° when the rateof change is stable.

The number of the one or more arrows may be selected based on amagnitude of the rate of change.

The unitary icon may possess a background color based on at least thecurrent glucose level.

The background color may be a first color when the current glucose levelis associated with a high glucose level, a second color when the currentglucose level is associated with a target glucose level, and a thirdcolor when the current glucose level is associated with a low glucoselevel.

The first interface may further include a graph displaying a pluralityof glucose levels over a predetermined period of time. The plurality ofglucose levels may include a plurality of data points representative ofthe current glucose level and one or more historical values.

The graph may be separated into one or more of a first band associatedwith a high glucose level, a second band associated with a targetglucose level, and a third band associated with a low glucose level. Thefirst band, the second band, and the third band may be different colors.

The current glucose level may be displayed on a right-most side of thegraph in a current band. The current band may include the first band,the second band, or the third band. The color of the current band maymatch the background color of the unitary icon.

The plurality of data points may include at least a first data pointtype and a second data point type. The current glucose level may bedisplayed on the graph using the first data point type. The one or morehistorical values may be displayed on the graph using the second datapoint type.

The first data point type may be a first circle having a black borderand a white background. The second data point type may be a secondcircle having a black border and a black background.

The plurality of data points may further include a third data point typerepresentative of an event. The event may be associated with a nearestone of the plurality of data points.

The third data point type may be a shape that surrounds the first datapoint type or the second data point type.

A description of the event may be displayed on the first interface whenthe third data point type is selected.

A second interface may be displayed when the screen is rotated. Thesecond interface may include an extended view of the graph in the firstuser interface over a user-selected period of time. The user-selectedperiod of time may be one hour, three hours, six hours, twelve hours, ortwenty-four hours.

A miniature icon may be displayed on the second interface when one ofthe plurality of data points is selected. The miniature icon may displaya glucose level associated with the selected data point. The miniatureicon may further include a background color based on a value of theselected data point relative to one or more threshold values.

The first interface may further include a second icon that indicateswhether a mute switch on the device is enabled.

The first interface may further include a third icon that indicateswhether a calibration measurement is needed.

The first interface may further include a fourth icon that allows one ormore events to be entered when the fourth icon is selected. The one ormore events may be associated with one or more of food consumption,beverage consumption, exercise, and administration of a substance.

The first interface may further include a fifth icon that indicateswhether remote monitoring is enabled, disabled, or experiencing anerror.

The current glucose level may be shared with one or more remote monitorsapproved by the patient when the remote monitoring is enabled. Theremote monitoring may experience an error when the device is unable toconnect with one or more remote monitors approved by the patient.

The fifth icon may have a first color when the remote monitoring isdisabled. The fifth icon may have one or more colors when the remotemonitoring is enabled. The one or more colors may be different from thefirst color. The fifth icon may have a badge when the remote monitoringis experiencing an error.

The unitary icon may include a circular shape with one or more arrowsthat rotate about the circular shape based on the rate of change of thecurrent glucose level.

The current glucose level may be displayed inside the circular shape.

In another aspect, a current glucose level of a patient and a rate ofchange of the current glucose level are accessed. A clinical risk to thepatient is determined. A first interface is displayed on a screen of adevice. The first interface includes a visualization of the clinicalrisk and a unitary icon. The unitary icon displays the current glucoselevel and a visualization of the rate of change.

The above methods, apparatus, and computer program products may, in someimplementations, further include one or more of the following features.

The determining the clinical risk may be based on the current glucoselevel and the rate of change. The clinical risk may be associated withan extrapolated glucose level.

The rate of change may be based on at least the current glucose leveland a second value. The second value may be representative of theglucose level of the patient at a second time. The second time mayprecede a time associated with the current glucose level.

The clinical risk may be high when one or more of the followingconditions are satisfied: the current glucose level is greater than afirst threshold value and the rate of change is increasing; the currentglucose level is greater than the first threshold value and the rate ofchange is stable; the current glucose level is less than a secondthreshold value and the rate of change is decreasing; and the currentglucose level is less than the second threshold value and the rate ofchange is stable.

The clinical risk may be low when one or more of the followingconditions are satisfied: the current glucose level is greater than thefirst threshold value and the rate of change is decreasing; the currentglucose level is less than the second threshold value and the rate ofchange is increasing; and the current glucose level is between the firstthreshold value and the second threshold value and the rate of change isstable.

The visualization of the clinical risk may include shading the screen ofthe device with a first color when the clinical risk is high. Thevisualization of the clinical risk may include shading the screen of thedevice with a second color when the clinical risk is low.

The visualization of the clinical risk may include incorporating a colorgradient into a background of the unitary icon. The color gradient mayinclude a plurality of colors. The plurality of colors may be arrangedin a pattern to illustrate the clinical risk.

The visualization of the clinical risk may include displaying theextrapolated glucose level on a second unitary icon.

The visualization of the rate of change may include one or more arrowsoriented in a first direction. The first direction may be representativeof whether the current glucose level is increasing, decreasing, orstable.

The one or more arrows oriented in the first direction may have a firstpointing direction of 0° when the rate of change is increasing, may havea second pointing direction of 180° when the rate of change isdecreasing, or may have a third pointing direction of 90° when the rateof change is stable.

A number of the one or more arrows may be selected based on a magnitudeof the rate of change.

The visualization of the clinical risk may include flashing the one ormore arrows.

The visualization of the clinical risk may include enlarging the one ormore arrows.

The visualization of the clinical risk may include shading the one ormore arrows and a background of the unitary icon with different colors.

The determining the clinical risk may be further based on one or moreevents. The one or more events may be associated with one or more offood consumption, beverage consumption, exercise, and administration ofa substance.

One or more of the current glucose level and the rate of change may bedisplayed on a locked screen when the device is locked.

In an additional aspect, an application is executed to generate one ormore alerts on a device relating to a glucose level of a patient. Theexecuting includes accessing a current glucose level of a patient. Theexecuting also includes accessing one or more conditions associated withthe one or more alerts. The one or more conditions define a relationshipbetween the current glucose level and one or more threshold values. Theexecuting further includes determining whether the one or moreconditions are satisfied. The executing also includes generating the oneor more alerts when the one or more conditions are satisfied. The one ormore alerts that are generated are based on one or more of a state ofthe device and a state of the application.

The above methods, apparatus, and computer program products may, in someimplementations, further include one or more of the following features.

The state of the device may include one or more of a locked state, anunlocked state, a muted stated, and an unmuted state. The state of theapplication may include an active state or an inactive state.

The application may be in an active state when the application isdisplayed on a foreground of a screen of the device. The application maybe in an inactive state when the application is displayed on abackground of the screen of the device.

The one or more alerts may include one or more non-audible alerts whenthe device is in a muted state. The one or more non-audible alerts mayinclude one or more of a vibration or a visualization displayed on ascreen of the device. The visualization may include a flashing screen ora shaded screen.

The one or more alerts may include one or more local notificationsdisplayed on a locked screen of the device when the device is in alocked state. The one or more local notifications may display anidentifier associated with the one or more alerts.

The one or more local notifications may further display the currentglucose level and a trend arrow representative of a rate of change ofthe current glucose level.

The one or more alerts may include one or more banners when the deviceis in an unlocked state and when the application is in an inactivestate. The one or more banners may display an identifier associated withthe one or more alerts for a predetermined period of time on a screen ofthe device.

The one or more alerts may further include one or more audible alerts.

The one or more alerts may be re-generated at a predetermined frequencyuntil an acknowledgment of the one or more alerts is received or whenthe one or more conditions are no longer satisfied.

The one or more alerts may include an urgent low alert, a low alert, ahigh alert, a rise rate alert, a fall rate alert, or a no data alert.

The urgent low alert may not be modifiable.

The one or more threshold values associated with the one or more alertsmay be adjusted during a predetermined period of time. The adjusting maycause the one or more conditions of one or more alerts to be satisfiedmore frequently than without the adjusting. The adjusting may beperformed during a night mode.

In yet another aspect, one or more alerts relating to a glucose level ofa patient are maintained. The one or more alerts are generated when oneor more conditions are satisfied. The one or more conditions define arelationship between a current glucose level of the patient and one ormore threshold values. It is detected whether a mute function on thefirst device is enabled. The generation of the one or more alerts ismodified based on the detecting.

The above methods, apparatus, and computer program products may, in someimplementations, further include one or more of the following features.

The patient may be notified that the mute switch is enabled using one ormore notifications. The notifying may be based on the detecting.

An image may be displayed on a screen of the first device. The image mayindicate that the mute function is enabled on the first device. Amessage may be displayed on the screen. The message may indicate thatthe mute function is enabled on the first device. An e-mail may be sentto the patient. The e-mail may indicate that the mute function isenabled on the first device.

One or more vibrating alerts may be generated until an acknowledgment ofthe one or more notifications is received.

A message may be sent to a second device. The message may cause thesecond device to notify one or more remote monitors of the patient thatthe mute function is enabled on the first device.

The modifying may include initiating a communication with one or moreremote monitors of the patient. The communication may indicate that theone or more conditions of the one or more alerts are satisfied. Thecommunication may include one or more of a phone call, a text message,and an e-mail.

The modifying may include sending a message to a second device. Themessage may indicate that the one or more conditions of the one or morealerts on the first device are satisfied and may cause the second deviceto generate the one or more alerts.

The modifying may include adjusting the one or more threshold values.The adjusting may cause the one or more conditions of the one or morealerts to be satisfied more frequently than without the adjusting. Theadjusting the one or more threshold values may be performed during apredetermined period of time.

A message may be sent to a pump in communication with the first device.The message may cause the pump to suspend delivery of a medication tothe patient.

In another aspect, an application is executed on a first device formonitoring a glucose level of a patient. It is determined whether theapplication on the first device has stopped execution. A notification isgenerated based on the determination. The notification indicates thatthe application has stopped execution.

The above methods, apparatus, and computer program products may, in someimplementations, further include one or more of the following features.

The notification may be generated before the application has stoppedexecution and may indicate that the application will terminate.

The notification may be locally generated on the first device.

A message may be sent to a second device. The message may cause thesecond device to notify one or more remote monitors of the patient thatthe application has stopped execution.

The application may be activated upon receiving a communication from athird device. The communication may be associated with an operation ofthe application. The first device and the third device may be pairedusing a Bluetooth connection.

An alarm may be set on the first device. The alarm may be configured tobe activated at a predetermined time. The alarm may be reset on thefirst device before the alarm is activated by extending thepredetermined time. Determining whether the application has stoppedexecution may be based on an activation of the alarm.

The notification may be generated upon receiving a message indicatingthat the application has failed to communicate with a second deviceduring a predetermined period of time.

The determining may include determining whether a battery of the firstdevice has sufficient power to continue operation of the first deviceduring a predetermined period of time.

It is to be understood that both the foregoing general description andthe following detailed description are exemplary and explanatory onlyand are not restrictive. Further features and/or variations may beprovided in addition to those set forth herein. For example, theimplementations described herein may be directed to various combinationsand subcombinations of the disclosed features and/or combinations andsubcombinations of several further features disclosed below in thedetailed description.

BRIEF DESCRIPTION OF THE DRAWINGS

The patent or application file contains at least one drawing executed incolor. Copies of this patent or patent application publication withcolor drawing(s) will be provided by the Office upon request and paymentof the necessary fee.

The accompanying drawings, which are incorporated herein and constitutea part of this specification, show certain aspects of the subject matterdisclosed herein and, together with the description, help explain someof the principles associated with the subject matter disclosed herein.In the drawings,

FIG. 1 illustrates a continuous analyte sensor in accordance with someexemplary implementations;

FIG. 2A illustrates a system diagram in accordance with some exemplaryimplementations;

FIG. 2B illustrates a functional block diagram of the continuous glucosemonitoring application in accordance with some exemplaryimplementations;

FIG. 3A illustrates a user interface for a mobile computing device inaccordance with some exemplary implementations;

FIGS. 3B and 3C illustrate user interfaces for entering events inaccordance with some exemplary implementations;

FIGS. 3D-3G illustrate user interfaces for adjusting remote monitoringsettings in accordance with some exemplary implementations;

FIG. 3H illustrates user interfaces for calibrating a glucose monitor inaccordance with some exemplary implementations;

FIG. 3I illustrates a menu in accordance with some exemplaryimplementations;

FIG. 3J illustrates a user interface for displaying transmitterinformation in accordance with some exemplary implementations;

FIGS. 4A and 4B illustrate various views of a user interface forproviding glucose level information in accordance with some exemplaryimplementations;

FIGS. 5A-5D illustrate various views of a user interface in reflectionmode in accordance with some exemplary implementations;

FIGS. 6A-6C illustrate various views of a user interface in reflectionmode in accordance with some exemplary implementations;

FIGS. 7A-7E illustrate various views of a user interface in reflectionmode in accordance with some exemplary implementations;

FIGS. 8A-8D illustrate various views of user interfaces that display auser's clinical risk in accordance with some exemplary implementations;

FIG. 9A illustrates a process for generating an alert in accordance withsome exemplary implementations;

FIG. 9B illustrates user interfaces for managing a user's alerts inaccordance with some exemplary implementations;

FIGS. 10A and 10B illustrate user interfaces for a low alert inaccordance with some exemplary implementations;

FIG. 11 illustrates user interfaces for an urgent low alert inaccordance with some exemplary implementations;

FIG. 12 illustrates user interfaces for a high alert in accordance withsome exemplary implementations;

FIG. 13 illustrates user interfaces for a rise rate alert in accordancewith some exemplary implementations;

FIG. 14 illustrates user interfaces for a fall rate alert in accordancewith some exemplary implementations;

FIG. 15 illustrates user interfaces for a no data alert in accordancewith some exemplary implementations;

FIGS. 16A-16C illustrate various user interfaces for an alert inaccordance with some exemplary implementations;

FIG. 17 illustrates a user interface for night mode operation inaccordance with some exemplary implementations;

FIG. 18 illustrates a process for issuing an alert when a computingdevice is in mute mode in accordance with some exemplaryimplementations;

FIG. 19 illustrates a user interface for a muted computing device inaccordance with some exemplary implementations; and

FIG. 20 illustrates a process for issuing an alert when the continuousglucose monitoring application has stopped running in accordance withsome exemplary implementations.

Like labels are used to refer to same or similar items in the drawings.

DETAILED DESCRIPTION

A continuous glucose monitoring system can closely monitor a patient'sglucose levels at frequent intervals. By increasing the frequency ofglucose level measurements and sending these measurements to thepatient, the patient may be able to prevent prolonged durations of highglucose levels which may damage tissues over time and prevent or shortenthe duration of dangerously low glucose levels. The continuous glucosemonitoring system may have a dedicated display device, such as areceiver. A patient or a remote monitor may use this receiver to viewthe patient's glucose levels and receive alerts when the patient'sglucose level becomes high or low. Because patients may find itcumbersome to carry a separate glucose monitoring device, it may beadvantageous to incorporate the receiver's functionality into amulti-functional computing device, such as a smart phone or otherhand-held device.

FIG. 1 depicts an exemplary system that includes a continuous analytesensor system (e.g., continuous glucose meter) 8. The continuous analytesensor system 8 may include a sensor electronics module 12 and acontinuous analyte sensor 10 that is connected to a patient 100. Thesystem may include other devices and/or sensors, such as medicamentdelivery pump 2 and blood glucose meter 4. The continuous analyte sensor10 may be physically connected to sensor electronics module 12 and maybe integral with (e.g., non-releasably attached to) or releasablyattachable to the continuous analyte sensor 10. The sensor electronicsmodule 12, medicament delivery pump 2, and/or blood glucose meter 4 maycouple with one or more devices, such as display devices 14, 16, 18, and20.

It should be understood that FIG. 1 is for illustrative purposes, andthat the system can include other components as well. For example, thesystem can further include a gastric pacemaker that communicates withthe continuous analyte sensor system 8 and medicament delivery pump 2.The components of the system can communicate with one another to triggergastric pacemaker to perform pacing to promote processing of food/drinkof the patient. To illustrate, the continuous glucose sensor system 8can trigger a message to the gastric pacemaker to begin pacing if ahyperglycemic event has been detected by the system, or to stop pacingwhen measured glucose levels are below or within predefinedthreshold(s).

The system can also communicate to other devices in someimplementations. For example, the system can communicate withelectronics of an automobile. A display of the automobile electronicscan be used as a display device to display and/or alert a user ofglucose levels measured by the analyte sensor system 8. Further, theautomobile electronics can facilitate operation of the automobiledepending upon glucose levels measured by the analyte sensor system. Forinstance, the automobile electronics can disable ignition if the glucoselevels are too low, or pull the automobile over to the side of the roadand stop in an instance where the automobile includes autonomous drivingcapabilities.

In some exemplary implementations, the system may include a cloud-basedanalyte processor 114 configured to analyze analyte data (and/or otherpatient related data) provided via network 120 (e.g., via wired,wireless, or a combination thereof) from sensor system 8 and otherdevices, such as display devices 14, 16, 18, and 20, associated with thehost (also referred to as a patient). Cloud-based analyte processor 114may be configured to generate reports providing high-level information,such as statistics, regarding the measured analyte over a certaintimeframe.

In some exemplary implementations, the sensor electronics module 12 mayinclude electronic circuitry associated with measuring and processingdata generated by the continuous analyte sensor (e.g., continuousglucose meter) 10. This generated continuous sensor data may alsoinclude algorithms, which can be used to process and calibrate thecontinuous sensor data, although these algorithms may be provided inother ways as well. The sensor electronics module 12 may includehardware, firmware, software, or a combination thereof to providemeasurement of levels of the analyte via a continuous analyte sensor,such as a continuous glucose sensor.

The sensor electronics module 12 may couple (e.g., wirelessly and thelike) with one or more devices, such as display devices 14, 16, 18,and/or 20. The display devices 14, 16, 18, and/or 20 may be configuredto present (and/or alarming) information, such as sensor informationtransmitted by the sensor electronics module 12 for display at thedisplay devices 14, 16, 18, and/or 20. In some implementations, displaydevices 14, 16, 18, and/or 20 may implement the algorithms performed bysensor electronics module 12.

The display devices may include a relatively small, key fob-like displaydevice 14, a relatively large, hand-held display device 16, a cellularphone (e.g., a smart phone, a tablet, and the like) 18, a computer 20,and/or any other user equipment configured to at least presentinformation (e.g., a medicament delivery information, discreteself-monitoring glucose readings, heart rate monitor, caloric intakemonitor, and the like).

In some exemplary implementations, the relatively small, key fob-likedisplay device 14 may comprise a wrist watch, a belt, a necklace, apendent, a piece of jewelry, an adhesive patch, a pager, a key fob, aplastic card (e.g., credit card), an identification (ID) card, and/orthe like. This small display device 14 may include a relatively smalldisplay (e.g., smaller than the large display device) and may beconfigured to display certain types of displayable sensor information,such as a numerical value and an arrow.

In some exemplary implementations, the relatively large, hand-helddisplay device 16 may comprise a hand-held receiver device, a palm-topcomputer, and the like. This large display device may include arelatively large display (e.g., larger than the small display device)that may be configured to display information, such as a graphicalrepresentation of the continuous sensor data including current andhistoric sensor data output by sensor system 8.

In some exemplary implementations, the continuous analyte sensor (e.g.,continuous glucose meter) 10 comprises a sensor for detecting and/ormeasuring analytes, and the continuous analyte sensor 10 may beconfigured to continuously detect and/or measure analytes as anon-invasive device, a subcutaneous device, a transdermal device, and/oran intravascular device. In some exemplary implementations, thecontinuous analyte sensor 10 may analyze a plurality of intermittentblood samples, although other analytes may be used as well.

In some exemplary implementations, the continuous analyte sensor 10 maycomprise a glucose sensor configured to measure glucose in the bodyusing one or more measurement techniques, such as enzymatic, chemical,physical, electrochemical, spectrophotometric, polarimetric,calorimetric, iontophoretic, radiometric, immunochemical, and the like.In implementations in which the continuous analyte sensor 10 includes aglucose sensor, the glucose sensor may comprise any device capable ofmeasuring the concentration of glucose and may use a variety oftechniques to measure glucose including invasive, minimally invasive,and non-invasive sensing techniques (e.g., fluorescent monitoring), toprovide a data, such as a data stream, indicative of the concentrationof glucose in a patient 100. The data stream may be raw data signal,which is converted into a calibrated and/or filtered data stream used toprovide a value of glucose to a user, such as a patient or a remotemonitor (e.g., a parent, a relative, a guardian, a teacher, a doctor, anurse, or any other individual that has an interest in the wellbeing ofthe patient). Moreover, the continuous analyte sensor 10 may beimplemented as at least one of the following types of sensors: animplantable glucose sensor, a transcutaneous glucose sensor, implantedin a host vessel or extracorporeally, a subcutaneous sensor, arefillable subcutaneous sensor, an intravascular sensor, and anon-invasive analyte sensor.

Although the description herein refers to some implementations thatinclude a continuous analyte sensor 10 comprising a glucose sensor, thecontinuous analyte sensor 10 may comprises other types of analytesensors as well. Moreover, although some implementations refer to theglucose sensor as an implantable glucose sensor, other types of devicescapable of detecting a concentration of glucose and providing an outputsignal representative of glucose concentration may be used as well.Furthermore, although the description herein refers to glucose as theanalyte being measured, processed, and the like, other analytes may beused as well including, for example, ketone bodies (e.g., acetone,acetoacetic acid and beta hydroxybutyric acid, lactate, etc.), glucagon,Acetyl Co A, triglycerides, fatty acids, intermediaries in the citricacid cycle, choline, insulin, cortisol, testosterone, and the like.

FIG. 2A depicts a system 200 for exchanging and communicating glucoselevel data among various components in accordance with someimplementations. System 200 is a variation of the system of FIG. 1A. Inparticular, system 200 includes additional components that may receiveand/or exchange information with sensor system 8 and further identifiesthe features of network 120. Patient 100 may have a continuous glucosesensor system 8 on his or her body. Sensor system 8 may be applied topatient 100 using an application device 7. Data receiver 16 and aprimary hand held computing device 18 may communicate with the sensorsystem 8. The system may also include one or more desktop or laptopcomputing devices 20, a network 120 that includes one or more servers,one or more secondary hand held computing devices 19, and one or moreadditional persons who monitor the performance of the system. Theseother persons can include technical support personnel 220, productperformance monitoring personnel 222, and remote monitors (e.g., familymembers, guardians, doctors, nurses) 224.

The continuous glucose sensor system 200 may include various connectionsbetween the electronic components. Sensor system 8 may be connected toprimary hand held computing device 18 and receiver 16 via a low-energy,close proximity wireless connections 212. In some implementations,connection 212 may utilize Bluetooth® wireless technology. Receiver 16and laptop or desktop computing device 20 may be connected via a wiredand/or wireless connection 14. This wired and/or wireless connection 14may utilize Universal Serial Bus (USB) ports, FireWire (e.g., IEEE 1394High Speed Serial Bus) ports, and the like. Sensor system 8 mayestablish a constant or intermittent connection with primary hand heldcomputing device 18 and receiver 16. In some implementations, receiver16 and/or primary hand held computing device 18 may establish a constantor intermittent connection with sensor system 8. These intermittentconnections may be established at one or more predetermined frequencies,such as every 3, 5, 7, or 10 minutes and the like.

Once a connection is established between sensor system 8 with one ormore of receiver 16 and the primary hand held computing device 18, datacorresponding to one or more glucose levels from patient 100 may beexchanged between these components. In some implementations, sensorsystem 8 may establish only one connection at a time such that such thatthe sensor system is either connected to receiver 16 or to primary handheld computing device 18. Each connection may be automatically ended oractively ended, such as after a predetermined amount of data has beentransferred, after a predetermined amount of time, or after a user hasinitiated disconnection.

In some implementations, receiver 16 may be connected with computingdevice 20 via a device cradle. This cradle may connect electricalcontacts on receiver 16 to a port on laptop or desktop computing device20. Primary and secondary computing hand held devices 18 and 19 andlaptop or desktop computing device 20 may communicate with each othervia network 120.

Network 120 may include servers 230, 232, 234, and 240. In someimplementations, servers 230, 232, 234, and 240 may be located in thecloud. While these servers are illustrated as separate devices in theimplementation of FIG. 2A, they may be consolidated as a single server,or one or all of these illustrated servers may be distributed acrossmultiple devices or servers.

In the systems of FIGS. 1 and 2A, patient 100 or another user maydiscreetly monitor the patient's current glucose level and clinicalrisk, as well as the functioning of the continuous glucose monitoringsensor system 8. The other user may be a remote monitor, such as aparent, guardian, physician, nurse, and the like. These remote monitorsmay remotely monitor the status of patient 100 using a hand heldcomputing device 19. Remote monitoring server 230 may receive glucoselevel data from primary hand-held computing device 18 or computingdevice 20 and push this data to remote monitor devices 19. This data mayalso include settings for communicating with the remote monitor device19. In some implementations, remote monitoring server 230 may also pushone or more alerts to remote monitors as described below with respect toFIGS. 3E-G. Hand held computing device 19 may be a mobile smart phone, atablet computer, a music or video player device with Internetconnectivity, and the like. Although FIG. 2A illustrates remote monitordevice 19 as a smart phone, the remote monitor may also access thisinformation via a website, at a desktop computing device 19, and thelike. In some implementations, the patient's hand held computing device18 may be used in conjunction with receiver 16. Using both a dedicatedreceiver 16 and a hand held computing device 18 may provide insuranceagainst scenarios where one of the devices 16 or 18 fails. Thisredundancy also provides a safeguard for receiving alarm notificationsif, for example, one of the devices is placed in a silent mode ormalfunctions.

Compatibility server 232 may ensure the compatibility of the variouscomponents in the system. This may include the compatibility of software(e.g., operating systems) running on devices 18, 19, and/or 20 withother components or necessary functions of system 200. Data sync server234 may collect and store data and synchronize data transfer withadditional components according to pre-defined permissions. For example,data sync server 234 may synchronize data with data analysis andreporting server 240 and product performance monitoring server 250.

In some implementations, system 200 of FIG. 2A may include one or moreadditional servers configured to monitor the performance of the system.User data server 236 may maintain medical information regarding users ofthe system (e.g., patient 100, remote monitors, and the like). Productperformance monitoring server 250 may monitor the functioning of sensorsystem 8 and servers 230, 232, 234, and 240. Server 242 may provideaccount information, such as sign-on or login information, for accessingthe various servers in system 200.

FIG. 2B illustrates a functional block diagram of the continuous glucosemonitoring application 255 running on computing devices 18 and/or 19.This block diagram includes various software modules or features thatcontrol the behavior of application 255. For ease of explanation, thesoftware modules or features of application 255 are described as beingperformed by computing devices 18 and/or 19. However, these softwaremodules and features may be performed by other devices including, forexample, cloud based analyte processor 114, any of servers 230, 232,234, 236, 240, 242, and 250, or any combination thereof. The softwaremodules and features of application 255 may include a data review module264, an event recording module 285, a remote monitoring module 290, acalibration module 280, and an alert module 275. Each of these modulesis described below.

Data review module 264 may display a patient's glucose levels. Asdescribed below with respect to FIGS. 4A-8D, the data review module 264may provide information regarding a patient's current glucose level andits rate of change. Data review module 264 may also display a trendgraph that illustrates variations in a patient's glucose level over timeand may also indicate the presence of a clinical risk to the patient.

Remote monitoring module 290 may share a patient's glucose levelinformation with other users, such as remote monitors 224. As describedabove with respect to system 200, share server 230 may push thisinformation to secondary computing devices 19. A patient may use remotemonitoring module 290 to invite remote monitors to receive thisinformation and customize the type of information that may be viewed byinvited remote monitors. Remote monitoring module 290 is described belowwith respect to FIGS. 3D and 3E.

A patient may use event recording module 285 to enter and recall events.Events may include food intake, medication intake, exercise, and thelike. By recording this information, the patient may obtain a betterunderstanding of how different types of events may influence his or herglucose levels. Event recording module 285 is described below withrespect to FIGS. 3B and 3C.

Calibration module 280 may calibrate glucose data measurements receivedfrom sensor system 8. The calibration module 280 may alert a user whencalibration measurements are needed. Calibration module 280 is describedbelow with respect to FIG. 3H.

Alert module 275 may generate various alarms or alerts using glucoselevel alert module 276, mute mode alert module 278, and communicationfailure alert module 277. Glucose level alert module 276 may be asub-module of alert module 275 and may be configured to generate analarm if a patient's glucose level drops below or rises above apredetermined threshold value. A patient may use alert module 275 to setalerts for different parameters and designate which alerts to propagateto the remote monitors. Alert module 275 is described below with respectto FIGS. 9A-14 and 16A-17. Mute mode alert module 278 may be asub-module of alert module 275 and may be configured to alert a patientif the patient's computing device 18 is determined to be muted. Becausea patient may not hear any alerts when his or her device 18 is muted,mute mode alert module 278 may initiate one or more remedial actions,such as propagating one or more alerts to remote monitors. Mute modealert module 278 is described below with respect to FIGS. 18 and 19.Communication failure alert module 277 may be a sub-module of alertmodule 275 and may be configured to alert a patient or remote followerif application 255 is determined to be terminated. This notification mayprompt the patient to reboot or relaunch application 255 so that he orshe may continue receiving glucose level data from sensor system 8.Communication failure alert module 277 is described below with respectto FIGS. 15 and 20.

FIG. 3A illustrates a home screen 310 that may be displayed by datareview module 264 when application 255 is launched. A user, such as apatient and/or remote monitor, may use home screen 310 to assess thestatus and clinical risk of a patient and to access various featuresassociated with application 255. The home screen 310 may include one ormore user-selectable icons 340, 342, 344, 346, and 347. Selection of anicon may cause application 255 to perform a function related to the icon(e.g., display a pop-up menu or open a new window relating to thefunction). A description of icons 340, 342, 344, 346, and 347 isprovided below. Home screen 310 may also include a unitary icon 320 anda trend graph 330 that provides information regarding the patient'sglucose levels. The unitary icon 320 and trend graph 330 are describedin further detail below with reference to FIGS. 4A and 4B. Unitary icon320 may provide an overall representation of a patient's glucose level.Unitary icon 320 may include one or more graphics, one or more symbols,and the like. The graphics and/or symbols in unitary icon 320 may bestatic or may change based on the patient's glucose level. While thegraphics and/or symbols in unitary icon 320 are consolidated into asingle unified image in the implementation of FIG. 3A, unitary icon 320may be segmented into one or more non-contiguous graphics and/or symbolsin other implementations.

A user may select event entry icon 340 to access event recordingsoftware module 285. As described above, a user may use event recordingsoftware module 285 to enter information regarding events that mayaffect the patient's glucose level. Events may include, for example,recent meals (e.g., food and beverage consumption), periods of activityor exercise, the administration of medication (e.g., bolus of insulin),and the like. Entered event information may be used to analyze thepatient's health. In some implementations, as discussed below, eventmarkers may be displayed on a glucose trend graph to allow a user toretrospectively analyze how different types of events affect thepatient's glucose levels. The event information may also be used todetermine when alerts should be generated (e.g., generating an alert 30minutes after exercising) and whether adjustments are needed to thepatient's medication regime (e.g., prompting the patient to administer abolus of insulin after a particular event).

FIG. 3B illustrates an exemplary interface for entering meal-relatedevent information. This interface may be displayed on the user interfaceof the patient's device 18 upon selection of the event entry icon 340 ormay be automatically triggered when application 255 receives inputindicating that the patent has eaten or is about to eat. The input maybe one or more or time of day (e.g. lunchtime), a change in glucoselevels indicative of eating a meal (e.g., a rising glucose level),location (e.g., a GPS location corresponding to a restaurant), and thelike. A patient may use food input menu 1610 to provide informationregarding recent meals, such as breakfast 1622A, lunch 1624, dinner1626, and snacks 1628. Menu 1610 may include an area 1614 for loggingthe consumption of favorite foods. For example, if a user consumescoffee, eggs, bread, and fruit for breakfast, he or she may quickly logthese items by selecting icons 1632, 1634, 1636, and 1638, respectively.The food input menu 1610 may also display the patient's current or mostrecent glucose level reading 1616 and a trend graph 1620. Trend graph1620 may provide a graphical view of fluctuations in the patient'sglucose level over a particular period of time.

FIG. 3C illustrates another interface for entering event information.This interface may appear when the patient selects breakfast tab 1622Afrom FIG. 3B. Drop down menu 1630 may list various breakfast items, suchas coffee, eggs, toast, apple, granola, and the like. As a patient logshis or her food intake, event recording software module 285 may learnwhich foods are favored during each meal and appropriately populate dropdown menu 1630. Module 285 may use this information to populate favoritefoods section 1614 in FIG. 3B with different items. In someimplementations, the module 285 may change the favorite foods that aredisplayed based on the time of day (e.g., display breakfast foodsbetween 5 AM and 8 AM and display lunch foods between 11 AM and 1 PM).

Returning to FIG. 3A, icon 342 may dynamically change to indicatewhether remote monitoring is enabled. To illustrate, a patient may wishto share his or her glucose levels with one or more remote monitors,such as a parent, guardian, or physician, particularly when the patientis a child or elderly person. A patient may enable or disable remotemonitoring using primary device 18. In some circumstances, remotemonitoring may not be enabled if, for example, the patient has not yetsubscribed to the remote monitoring feature. Remote monitoring module290 may display the status of the remote monitoring function byadjusting the appearance of icon 342 according to a plurality of states.In one implementation, the icon may be displayed in one of three states:an active sharing state, a remote monitoring disabled state, and aremote monitoring error state. The various states may be visuallydistinguishable by, for example, changing the color of icon 342 and/ordisplaying one or more badges with icon 342. In one exemplaryimplementation, icon 342 is displayed in multiple colors when device 18is actively sharing data with other devices 19; icon 342 is displayed ina gray color when remote monitoring is disabled; and icon 342 isdisplayed in a gray color with a badge to indicate that device 18 isunable to share data due to a technical error (e.g., server 120 isunable to push date to secondary devices 19). It is understood that theabove implementation is merely an example of how the icon 342 mayvisually change based on the status of the remote monitoring function,and that other visual changes may be used instead of or in addition tothe above example.

FIGS. 3D and 3E illustrate multiple interfaces for controlling datasharing settings. When sharing is enabled, a patient may allow one ormore remote monitors to receive messages or alerts regarding thepatient's glucose levels. Remote monitoring module 290 may display datasharing subscription screen 380 if a user has not subscribed to theremote monitoring service. The user may select the “Learn More” buttonto obtain additional information regarding this service. When the “LearnMore” button is selected, the remote monitoring module 290 may launchand navigate a browser on device 18 to a website that providesadditional information regarding the remote monitoring service.Alternatively or additionally, the remote monitoring module may connectto a server (e.g., server 230) to display this information directlywithin application 255. If, however, the user has subscribed to theremote monitoring service, remote monitoring module 290 may display datasharing screen 381. Message 383 may provide the user with a textualexplanation about whether sharing is currently enabled and the type ofdata that may be viewed by the remote monitors. A patient may turnsharing on or off by toggling sharing button 381. Area 384 displaysinformation regarding the user's remote monitors (e.g., identifier nameand status indication) which may include invited remote monitors,removed remote monitors, and active remote monitors. A field may beassociated with each remote monitor. When a particular field isselected, remote monitoring module 290 may navigate to a page thatdisplays additional information regarding the selected remote monitor.The user may invite additional remote monitors by selecting button 382,which may initiate the remote monitor invitation process described belowwith respect to FIGS. 3E-3G.

FIGS. 3E-3H illustrates an exemplary workflow for the remote monitorinvitation process and may begin when, for example, a user selectsbutton 382 from data sharing screen 381. A user may enter remote monitorinformation using interface 400, as illustrated in the flow diagram ofFIG. 3E. This information 402 may include, for example, the remotemonitor's name and e-mail address. The system can send an invitation tothe remote monitor using the entered e-mail address. The user may enterthis information manually using keyboard 404. In some implementations,the user may add remote monitors from his or her contacts as illustratedin interfaces 406 and 408, which allows the application 255 toauto-populate the remote monitor's information.

The application 255 may allow the user to define the type of informationthat he or she wishes to share with remote monitors. For example, theuser may use interface 387 to indicate whether the selected remotemonitor has permission to see the user's glucose trend graphs. The usermay use interface 412 to identify which alerts should be generated onsecondary computing device 19. These alerts may include, for example, anurgent low notification 388A, a low notification 388B, a highnotification 388C, and a no data notification 388D. The urgent lownotification 388A and the low notification 388B may have certainthreshold values 414A and 416A that define when an alarm is triggered.For example, Eric2 may receive a “Low Notification” alert when theuser's glucose level is below 70 mg/dL for more than 30 minutes. Theuser may set threshold values 414A and 416A using interfaces 414B and416B, respectively. A user may recommend different alert settings foreach invited remote monitor during the invitation process describedabove with respect to FIG. 3E. The remote monitor may accept or modifythese alert settings in some implementations.

Returning to FIG. 3A, icon 344 may be a reference calibration icon. Whena calibration measurement is needed, calibration module 280 may displaya badge on icon 344. In the implementation of FIG. 3A, the badge mayinclude a circle with a number positioned over the calibration icon 344.This number may represent how many calibration readings are needed. Forinstance, during initialization or warm up of a new sensor system 8, twocalibrations may be needed. In some implementations, a calibrationmeasurement may be required at predetermined frequencies (e.g., every 12hours) or when erratic glucose level readings are detected by sensorsystem 8. Erratic data may be caused by a faulty sensor, illness,interfering components in the patient's bodily fluid, or electrostaticinterference with device electronics, for example.

FIG. 3H illustrates a user interface 390 for entering a calibrationmeasurement. Calibration module 280 may display user interface 390 whena user selects calibration icon 344 of FIG. 3A, for example. A user maybe prompted to measure his or her glucose level using an external bloodglucose meter when a badge appears on icon 344. The user may entermeasurement 392 into interface 390 using numerical keypad 394. Once theglucose measurement 392 is entered, interface 390 may prompt the user toconfirm the value and time 396 of the reading using OK button 398. Oncethese values are confirmed, the application may initiate calibration ofthe system using the entered value.

Returning to FIG. 3A, icon 346 may be a menu icon. Selecting icon 346may cause application 255 to display menu 360 illustrated in FIG. 3G. Auser may use menu 360 to view or change various features of application255. Menu 360 may include various submenus that allow a user to navigateto other screens and information. In the implementation of FIG. 3I, menu360 includes the following submenus: Trend 361 which, when selected,causes application 255 to display home screen 310 illustrated in FIG.3A; blood glucose meter 362 which, when selected, causes application 255to display the blood glucose entry screens illustrated in FIG. 3H;alerts 363 which, when selected, causes application to display the alertsetting screen 910 illustrated in FIG. 9B; transmitter information 364which, when selected, causes application 255 to display a screen thatcontains information about the transmitter currently being usedincluding, for example, the transmitter's serial number, activationdate, battery level, expiration date, and pairing information (i.e.,which devices the transmitter is currently paired with) as describedbelow with respect to FIG. 3J; history 365 which, when selected, causesapplication 255 to display a log of past actions including, for example,triggered alerts, entered events, a sensor session start time, a sensorsession stop time, share connectivity, and the like; reports 366 which,when selected, causes application 255 to display a screen that providesretrospective analysis of the user's data, including trend graphscomparing different timeframes of data and identification of patterns inselected timeframes of data; settings 367 which, when selected, causesapplication 255 to display information regarding how the applicationdisplays information (e.g., the height of the trend graph), user accountinformation, and factory settings; and start session 369 which, whenselected, causes application 255 to start a new sensor session if asensor session is not already under way. With regard to button 369, if asession is currently under way, then a stop session option may appearwhich allows the user to end the current sensor session.

When transmitter button 364 is selected, application 255 may displayexemplary interface 370 illustrated in FIG. 3H. Interface 370 displaysthe transmitter ID 372 of sensor system 8, whether the transmitter isdirectly paired with the patient's glucose sensor 374, and a pairingbutton that a user may select to initiate pairing the transmitter withthe current display device operating the application (e.g., device 18).

Returning to FIG. 3A, application 255 may display an icon on its userinterfaces to indicate that the user's device is muted. Users may notunderstand that enabling a mute mode on a hand held computing device,such as smart phone 18, may prevent application 255 from generatingaudible alerts. Icon 347 may indicate whether a mute mode on computingdevice 18 is enabled or disabled (e.g. via a mute switch on the device).When the mute mode is enabled as illustrated in this figure, application255 may be unable to generate any audible alerts on device 18.

FIG. 4A illustrates an exemplary user interface 300 that provides apatient's glucose level information. Data review module 264 may changethe information displayed in user interface 300 based on measurementsreceived from sensor system 8. For example, data review module 264 mayshows different representations 337A, 337B, 337C, 337D, 337E, 337F,337G, 337H, 3371, and 337J of home screen 310 as the patent's glucoselevel changes over a period of time. A patient may quickly anddiscreetly ascertain his or her current glucose level, the rate ofchange of the current glucose level, and risk status from user interface300. Interface 300 may be displayed on the patient's hand held computingdevice 18 as well as on remote monitor devices 19. User interface 300may have a home screen 310 that includes a unitary icon 320 and a graph330. Graph 330 may display the patient's glucose levels over apredetermined period of time.

A user, such as the patient or remote monitor, may quickly assess thepatient's current glucose value, its rate of change, and the patient'sstate by looking at unitary icon 320. Unitary icon 320 may besubstantially circular in shape and may display a numerical indicator324 that corresponds to the patient's current glucose value. Unitaryicon 320 may also include one or more arrows that indicate whether thepatient's current glucose value is increasing, decreasing, or stable(i.e., the rate of change). Background color 326 may change to indicatea patient's glycemic state, such as whether the patient's currentglucose level is low (e.g., hypoglycemic), in target, or high (e.g.,hyperglycemic) relative to various threshold values. These thresholdvalues may be provided by a user or as default values by application255.

Background 326 may dynamically change based on a determined clinicalstate of the user. For example, the background color 326 may be a firstcolor when the patient's current glucose level is high (e.g., greaterthan or equal to an upper threshold level 334, such as 210 mg/dL), asecond color when the patient's current glucose level is in a targetzone (e.g., between a lower threshold level 332 and an upper thresholdlevel 334, such as between 80 and 210 mg/dL), and a third color when thepatient's current glucose level is low (e.g., less than or equal to alower threshold level 332, such as 80 mg/dL). In the implementation ofFIG. 4A, the first color may be yellow (as illustrated at 326A), thesecond color may be gray (as illustrated at 326B), and the third colormay be red (as illustrated at 326C). In some implementations, differentcolors, patterns, or textures (e.g., a dotted or crosshatchedbackground) may be used alone or in combination in unitary icon 320 toillustrate the patient's current glucose level.

Unitary icon 320 may also visually change based on a current, determinedrate of change of the user's glucose level. For example, the unitaryicon may have a rate of change indicator 322 that points in differentdirections as it rotates about the perimeter of the unitary icon, asillustrated in FIG. 4A. The direction in which indicator 322 points mayrepresent a calculated rate of change of the patient's current glucoselevel. This rate of change may be based on current and historicalglucose measurements received from sensor system 8. In someimplementations, the direction in which indicator 322 points may berepresented by a numerical degree value. Moving clockwise around theperimeter of unitary icon 320, indicator 322 may point north towards thetop of user interface 300 (corresponding to a 0° pointing direction),east towards the right side of the user interface (corresponding to a90° pointing direction), south towards the bottom of the user interface(corresponding to a 180° pointing direction), and west towards the leftside of the user interface (corresponding to a 270° pointing direction).It is understood that the aforementioned degree values are exemplary,and that the pointing direction may be between 0° and 359°. For example,indicator 322 may have a pointing direction of 45° when it points in anortheast direction.

The indicator 322 may point north or northeast (i.e., have a pointingdirection between 0° and 90°) as illustrated at 322A, 322B, and 322Cwhen the patient's glucose level is increasing. In these cases, thepatient's glucose level may experience a positive rate of change at thecurrent point in time.

The indicator 322 may point east (i.e., have a pointing direction of90°) as illustrated at 322J when the patient's glucose level is stable.In some implementations, indicator 322 may point west (i.e., have apointing direction of 270°) or omitted altogether from unitary icon 320when the patient's glucose level is stable.

The indicator 322 may point south (i.e., have a pointing direction of180°) or southeast (i.e., have a pointing direction between 90° and180°) as illustrated at 322E, 322F, 322G, 322H, and 322I when thepatient's glucose level is decreasing.

The indicator 322 may include one or more arrows or triangles toindicate how quickly a patient's glucose level is increasing ordecreasing. For example, indicator 322C may include two arrows thatpoint north (i.e., at a 0° pointing direction) to indicate that theglucose level is increasing rapidly. In another example, indicators 322Fand 322I may include two arrows that point south (i.e., at a 180°pointing direction) to indicate that the glucose level is decreasingrapidly. The number of arrows in arrow indicator 322 may vary based onthe magnitude of the rate of change.

Data review module 264 may compare the calculated rate of change to oneor more predetermined ranges to determine the direction in whichindicator 322 points and the number of indicators to display. Thesepredetermined ranges may be automatically set as default values ormanually set by an administrator or the patient. For illustrativepurposes, the following examples describe how data review module 264 maymake these determinations:

-   -   If the rate of change of the current glucose value is between        −0.5 and 0.5, then indicator 322 may point east or west (i.e.,        have a pointing direction of approximately 90° or 270°,        respectively) with one arrow to indicate that the rate of change        is stable. In some implementations, indicator 322 may be absent.    -   If the rate of change of the current glucose value is between        0.6 and 1.5, then indicator 322 may point northeast (i.e., have        a pointing direction of approximately 0°-90°) with one arrow to        indicate that the rate of change is increasing.    -   If the rate of change of the current glucose value is between        1.6 and 2.5, then indicator 322 may point north (i.e., have a        pointing direction of approximately) 0° with one arrow to        indicate that the rate of change is increasing.    -   If the rate of change of the current glucose value is greater        than 2.5, then indicator 322 may point north (i.e., have a        pointing direction of approximately) 0° with two arrows to        indicate that the rate of change is increasing rapidly.    -   If the rate of change of the current glucose value is between        −1.5 and −0.5, then indicator 322 may point southeast (i.e.,        have a pointing direction of approximately 90°-180°) with one        arrow to indicate that the rate of change is decreasing.    -   If the rate of change of the current glucose value is between        −1.6 and −2.5, then indicator 322 may point south (i.e., have a        pointing direction of approximately) 180° with one arrow to        indicate that the rate of change is decreasing.    -   If the rate of change of the current glucose value is less than        −2.5, then indicator 322 may point south (i.e., have a pointing        direction of approximately) 180° with two arrows to indicate        that the rate of change is decreasing rapidly.

A patient or remote monitor may only have a brief amount of time toglance at home screen 310 to check the patient's glucose levels. In somesituations, the patient may want to check his or her glucose levelsdiscreetly without attracting the attention of others. Having easilyidentifiable indicators of the patient's glucose level and clinical riskmay be beneficial. In some implementations, data review module 264 mayincorporate different visual elements into trend graph 330 and unitaryicon 320 to represent the patient's current glycemic state. These visualelements may include different colors, textures, patterns, and the like.The strategic use of these visual elements may also allow the patient orremote monitor to quickly assess the patient's glucose levels anddetermine whether medical attention is needed at a glance.

The use of these visual elements may be incorporated into trend graph330 of FIG. 4A, for example. Graph 330 may include a trend line 336 thatshows how a patient's glucose level changes over a predetermined periodof time. The current glucose level may be displayed as the right-mostdata point on graph 330. The current glucose level may correspond to theuser's glucose level at the present time or the most recently receivedglucose level. Graph 330 may include one or more horizontal bands, suchas a first band 343, a second band 338, and a third band 341. The bandsmay be defined by high and low threshold values which are illustrated ashorizontal lines 334 and 332, respectively. These threshold values maybe visually distinct from one another. For example, graph 330 mayinclude an upper threshold value 334 in a first color (e.g., yellow),and a lower threshold value 332 in a different second color (e.g., red).The upper threshold value 334 may be 210 mg/dL of glucose, and the lowerthreshold value 332 may be 85 mg/dL of glucose, for example. However,any value may be chosen by a user, as discussed further herein. Forillustrative purposes only, glucose levels greater than or equal to theupper threshold value 334 (i.e., within band 343) may be interpreted ashigh glucose levels; glucose levels less than or equal to the lowerthreshold value 332 (i.e., within band 341) may be interpreted as lowglucose levels; and glucose levels between the lower threshold value 332and upper threshold value 334 (i.e., within band 338) may be interpretedas target glucose levels.

Bands 343, 338, and 341 may represent different ranges of glucoselevels. In order to distinguish one band from another, bands 343, 338,and 341 may be visually different. In some embodiments, each band may beshaded with a different color or colors. Other forms of visualdistinction may also be used including the use of different textures orpatterns as described above. The use of different visual elements mayfacilitate quick visual recognition of whether a patient's most recentlymeasured glucose level is high, in target, or low.

In the implementation of FIG. 4A, for example, when the patient'scurrent glucose level is in target, then bands 343 and 341 may be whiteor void of color, and band 338 may be gray. When the patient's currentglucose level exceeds the high threshold 334, then band 343 may changescolors, such as from white to yellow. When the patient's current glucoselevel falls below the low threshold 332, then band 341 may changecolors, such as from white to red. Note, in this implementation, thein-target band 338 remains the same color (e.g., gray) whether or notthe current glucose data point falls inside or outside of the in-targetrange.

The use of different visual elements may also be incorporated intounitary icon 320 in some implementations. Like the bands in trend graph330, the background color 326 of unitary icon 320 may correspondinglychange depending on whether the patient's current glucose level is high,in target, or low in the implementation of FIG. 4A. As illustrated,background color 326 may match the color of the band that the currentglucose value falls in. For example, when the patient's current glucoselevel is high (i.e., within band 343), then background color 326 ofunitary icon 320 may match the color of band 343. If, for example, band343 is yellow, then background color 326 may also be yellow. In anotherexample, when the patient's current glucose level is in target (i.e.,within band 338), then background color 326 may match the color of band338 (e.g., gray). In yet another example, when the patient's currentglucose level is low (i.e., within band 341), then background color 326may match the color of band 341 (e.g., red).

Trend line 336 may include a plurality of glucose value markers orglucose data points. Each data point may correspond to a particularglucose level measured at a particular time. These data points may berepresented differently depending on the band in which the data pointfalls and/or whether the data point is the current data point.

As an example, data points within a particular band may be the samecolor as all other data points within that band. That is, all datapoints in the same band are colored the same but are colored differentlythan data points falling within one or more other bands. For example,data points falling within band 341 are colored differently than datapoints falling within bands 338 and 343. However, data points fallingwithin band 338 can be colored the same.

In some implementations, the color of a data point may depend upon theband in which the current data point lies. In these implementations, thecolor of the data points within a particular band may change dependingon whether the current data point also falls within the same band. Forexample, as illustrated in the implementation of screen 337J, datapoints in band 341 may be a first color or shade when the current datapoint is in a different band (i.e., band 338). However, if the currentdata point is also in band 341, then the data points in this band maychange colors or shades from the first color or shade to a second coloror shade as illustrated in the implementations of screens 336G-336I.

While data points may change colors or shades depending on whether theylie in the same band as the current data point, this change may onlyoccur in certain bands, in accordance with some implementations. Forexample, this change may only occur for data points having a value thatis less than lower threshold value 332 (i.e., within band 341) but maynot apply to in-target data points (i.e., within band 338) or datapoints having a value greater than the upper threshold value 334 (i.e.,within band 343). This implementation can be beneficial to a user as itallows the user to differentiate a critical low glucose level from aless dangerous in target or high glucose level.

In some implementations, the data point corresponding to the currentglucose measurement may have its own unique visual representation thatis different from all other data points on trend graph 330. For example,while data points lying within the same band as the current data pointmay have the same color, the current data point may be a different colorand/or may be presented differently. For example, a border may be drawnaround the current data point. In another example, the current datapoint may be represented using a different shape (e.g., a star) insteadof the circular dots used for the other data points.

In some implementations, the colors of the data points may be chosen toprovide visual contrast from the color of the bands. This may be aparticular problem if, for example, a white data point is located withina yellow band. In these situations, data review module 264 may changethe color of the data point from white to black, for example, when aband is changed to yellow so that the black data point stands outagainst the yellow band.

FIG. 4A shows different representations 337A, 337B, 337C, 337D, 337E,337F, 337G, 337H, 3371, and 337J of home screen 310 over a period oftime. The view on the left side of FIG. 3A may correspond to theearliest point in time. The view on the right side of FIG. 3A maycorrespond to the latest point in time (e.g., the current time or themost recent point in time). Intermediate views may representintermediate points in time.

In views 337A, 337B, and 337C the patient's current glucose level ishigh (i.e., the current data point falls within band 343). The color ofband 343 (e.g., yellow) matches the background color 326A of unitaryicon 320. Indicators 322A, 322B, and 322C point north (i.e., have apointing direction of approximately 0°) or northeast (i.e., have apointing direction of approximately 0°-90°) to represent a positive rateof change in the patient's current glucose level.

In views 337D, 337E, and 337F the patient's current glucose levels iswithin target (i.e., within band 338). Consequently, the color of band338 (e.g., gray) matches the background color 326B of the unitary icon.Although the patient's current glucose level is within target in views337D, 337E, and 337F, the rate of change in each view is different asindicated by indicators 322D, 322E, and 322F.

For example, indicator 322D points east (i.e., have a pointing directionof approximately 90°) to indicate that there is no substantial change inthe patient's glucose level over time. Because the patient's currentglucose level is within target and the rate of change is stable, thepatient's glucose level remains steady. Indicators 322E and 322F,however, point southeast (i.e., have a pointing direction ofapproximately 90°-180°) and south (i.e., have a pointing direction of180°), respectively, to indicate that the rate of change of the currentglucose level is decreasing. The presence of two downward pointingtriangles in indicator 322F indicates that the rate of change isdecreasing rapidly (i.e., has a large magnitude) in view 337F.

In views 337G, 337H, and 3371, the patient's current glucose levels islow (i.e., within band 341). Consequently, the color of band 341 (e.g.,red) matches the background color 326C of the unitary icon. As trendlines 336G, 336H, and 336I move from band 338 into the band 341 (i.e.,from target glucose levels to low glucose levels), the indicator pointsin different directions to indicate how quickly the patient's glucoselevel is decreasing. For example, indicators 322G, 322H, and 322I movefrom pointing southeast (as illustrated at 322G) (i.e., have a pointingdirection of approximately 90°-180°) to pointing south (as illustratedat 322H) (i.e., have a pointing direction of approximately 180°). If thepatient's glucose level is decreasing rapidly (i.e., has a large rate ofchange magnitude), then two arrows are used as illustrated in indicator322I.

In view 337J, trend line 336J rises within band 341 to band 338 (i.e.,from a low glucose level to a target glucose level). As the currentglucose level is in the target range (i.e., within band 338), thebackground color 326D of the unitary icon 320 matches the band's color(e.g., gray). The indicator 322J points east (i.e., have a pointingdirection of approximately 90°) to indicate that the rate of change ofthe patient's glucose level is relatively stable, and that the patient'scurrent glucose level is not likely to change.

FIG. 4B illustrates another view 450 of user interface 300 that includesa unitary icon 320 and a trend graph 330. Unitary icon 320 indicatesthat the current or most recently received glucose level is 77 mg/dL.This current glucose value may correspond to data point 437 on theright-most side of trend graph 330. Data point 437 may be less thanlower threshold level 332, may lie in band 341, and may correspond to alow glucose value. In order to indicate that the patient's current ormost recent glucose value is low, data review module 264 may shade band341 and the background color of unitary icon 320 with a red color toindicate that the patient may require attention. Data points above trendline 332 may be black, and data points 441 and 437 below trend line 332may be white. The change in data point color from black to white mayprovide higher visual contrast between the data points and the color ofthe band. In addition, this change in color may allow a user to quicklydetermine how long the patient's glucose values have been low. Inaddition to using different colors to distinguish data points indifferent bands, data review module 264 may also use different graphics,shapes, sizes, and the like.

The current data point 437 may also be illustrated differently thanolder data points using different data point types. Doing so allows auser to quickly distinguish the current reading from historicalreadings. Data point 437 may be a circle having a black border and colorbackground fill. The color of the background fill may be white becausedata point 437 lies below threshold value 332. Previous or historicalglucose level readings may be illustrated using solid circles. The colorof the circles may be white or black depending on whether the data pointlies above or below threshold value 332 as described above.

Events may also be illustrated different than other data points. In someimplementations, an event marker may be placed around the data pointthat is closest in time to the event. Quick identification of eventsfrom a trend graph 330 may allow a patient or remote monitor to discernwhether an event may have influenced the patient's glucose levels. Anevent may be associated with the data point recorded at the time closestto when the event took place. In graph 330, data point 439 may beassociated with an event. If, for example, the patient consumed abeverage or administered a bolus of insulin and recorded this eventusing interface 1610, then a box may appear around the data pointclosest to the recorded event. In this implementation, the box has ablack border with a white background although other colors, shapes,patterns, and textures may be used.

FIGS. 5A, 5B, 5C, and 5D illustrate another view 350 (e.g., 350 in FIG.5A) of a user interface. View 350 may provide detailed informationregarding a patient's glucose level history and may correspond to areflection mode. Data review module 264 may enter reflection mode whencomputing device 18 and/or 19 detects that it has been rotated from aportrait orientation into a landscape orientation based on anaccelerometer input or the like.

FIGS. 5A, 5B, 5C, and 5D display various views of a trend graph as auser interacts with the user interface. Time may be shown on thehorizontal axis, and the glucose level may be illustrated on thevertical axis. These trend graphs may be similar to the trend graphsdescribed above with respect to FIG. 4A but may be extended over adifferent period of time (e.g., a longer or a shorter period of time).The implementation of FIGS. 5A, 5B, 5C, and 5D shows glucose levels overa default, twelve-hour period. Like the trend graphs of FIGS. 4A and 4B,the current or most recent glucose level reading may be shown on theright. Data points to the left of the current data point may representearlier readings. These trend graphs may include horizontal lines thatrepresent the lower and higher threshold values described above.

When a user hovers over or selects a data point, a miniature icon 920may appear above the data point nearest to the user's point ofinteraction with the user interface (e.g., the data point closest to thedetected position of the user's finger, stylus, mouse, etc.). Theminiature icon 920 may display a numerical value corresponding to theglucose level at the day and time displayed at the top of the graph.This day and time may be associated with the data point nearest to theuser's point of interaction with the user interface. The miniature icon920 may have a background color or fill to indicate whether the glucoselevel at that data point was low, in target, or high as described abovewith respect to FIG. 4A. As a user traces his or her pointing device(e.g., finger, mouse, stylus, and the like) along the trend graphsillustrated in FIGS. 5A, 5B, 5C, and 5D, a miniature icon 920 may appearat each data point. Although miniature icon 920 in FIGS. 5A, 5B, 5C, and5D do not include a rate of change indicator, this indicator may beincluded with the miniature icon to represent the rate of change at thatpoint in time in some implementations.

FIGS. 6A, 6B, and 6C illustrate additional views 351 of a user interfacein a reflection mode as the user interacts with event informationdisplayed on the user interface. Data review module 264 may generateviews 351 when computing device 18 and/or 19 detects that it has beenrotated into a horizontal position. This detection may be based on inputfrom an accelerometer within computing device 18 and/or 19, for example.The trend graphs in these views may include data points associated withevents 939A, 939B, and 939C. Data points associated with events may beillustrated differently than other data points, as described above. Inthe implementation of FIGS. 6A, 6B, and 6C, data points 939A, 939B, and939C may be illustrated with white boxes, and non-event data points maybe illustrated with solid black circles. Different colors, shapes,patterns, textures, sizes of data points, and the like may be used todistinguish data points associated with events from other data points.When data points 939A, 939B, or 939C are selected, icons 940A, 940B, or940C may appear. These icons may indicate the type of activitiesassociated with the events (e.g., a calibration event, food intake, andthe like). Additional information regarding these activities or eventsmay be displayed by selecting icons 940A, 940B, and 940C, including, forexample, the time of the event, any corresponding amount (e.g., caloriesconsumed), and the like.

FIGS. 7A, 7B, 7C, 7D, and 7E illustrate additional views 352 of a userinterface in a reflection mode. Data review module 264 may generateviews 352 when computing device 18 and/or 19 is rotated from a portraitorientation into a landscape orientation or held in the landscapeorientation. Views 352 may include trend graphs that span differentlengths of time. For example, in views 350 and 351 of FIGS. 5A-5D and6A-6C, respectively, the trend graphs display glucose level data over a12-hour period of time. If a user wishes to see more data (e.g., over a24 hour period of time) or less data (e.g., over a 3 hour period oftime) on the trend graph, the user may change the amount of data that isdisplayed using view 352. In view 352, one or more selectable timeframeicons (1 HR, 3 HR, 6 HR, 12 HR, and 24 HR) may be displayed at the topof the view. A user may select the desired timeframe icon to indicatethe amount of data that he/she wishes to see. These timeframe icons mayappear when a user is not interacting with the screen (e.g., computingdevice 18 and/or 19 does not detect any user input including thepresence of a touch or selection). Other actions, such as hand gestures,may also be used to increase or decrease the timeframe (e.g., swiping,pinching, and stretching the display on devices 18 and/or 19). Thesehour designations are merely exemplary and other increments may be used.The current time may be displayed on the right side of each trend graph.As the time period increases, more data points may be displayed, and thetrend line may resemble a continuous line. As the time period decreases,fewer data points may be displayed, and the individual data points maybecome more discernible because data points are generated at regularintervals, such as every five minutes. Allowing the user to adjust thetime scale and, consequently, the amount of data that is displayed mayhelp the user detect trends in the patient's glucose levels.

The application 255 running on hand held computing devices 18 and/or 19may provide a snapshot of the patient's current and previous glucoselevels. In some implementations, the application may also indicatewhether the patient is at risk in the near future of becominghypoglycemic or hyperglycemic. Providing risk information may bebeneficial as some users (i.e., patients and/or remote monitors) focussolely on the current glucose value without giving much thought towhether the value is dropping or increasing to dangerous levels. Thisclinical risk may be based on the patient's current or most recentglucose level and the rate of change. For illustrative purposes, theapplication may use the following guidelines to assess a patient's risklevel:

-   -   Patient's current glucose level is high, and the rate of change        is increasing=High clinical risk to patient;    -   Patient's current glucose level is low, and the rate of change        is decreasing=High clinical risk to patient;    -   Patient's current glucose level is low, and the rate of change        is stable (i.e., not changing)=High clinical risk to patient;    -   Patient's current glucose level is high, and the rate of change        is stable (i.e., not changing)=High clinical risk to patient;    -   Patient's current glucose level is high, and the rate of change        is decreasing=Low clinical risk to patient;    -   Patient's current glucose level is low, and the rate of change        is increasing=Low clinical risk to patient; and    -   Patient's current glucose level is in target, and the rate of        change is stable (e.g., not changing or relatively low rate of        change)=Low clinical risk to patient.

FIGS. 8A, 8B, 8C, and 8D illustrate various mechanisms for communicatinga patient's clinical risk level to a patient or remote monitor. Thesemechanisms may be used in isolation or in combination with each other toindicate a high clinical risk, a low clinical risk, or both.

FIGS. 8A and 8B illustrate an implementation for alerting a user of aclinically risky situation by applying a color scheme to the display ona hand held computing device. The hand held computing device in thesefigures may be running multiple applications. In the instantimplementation, the glucose monitoring application may be running in thebackground (i.e., inactive) as the user manipulates a differentapplication in the foreground. If the application determines that thepatient may enter a clinically risky state as described above, theapplication may apply a color scheme to shade the display with aparticular color. The color that is selected may be based on, forexample, whether it is determined that the patient is at risk ofbecoming hypoglycemic or hyperglycemic, whether the clinical risk is lowor high, and the like. In some implementations, one or more of theseparameters may be used in combination to determine the color scheme. Inthe implementation of FIG. 8A, the application may apply a red colorscheme 1710 to indicate that the patient may be in danger of becominghypoglycemic. In the implementation of FIG. 8B, the application mayapply a yellow color scheme 1720 to indicate that the patient may be indanger of becoming hyperglycemic. In some implementations, application255 may apply a red color scheme 1710 for a high-risk situation, ayellow color scheme 1720 for a moderate risk situation, and no shadingor a grey shading for a relatively low risk situation. The shading onthe screen may discreetly prompt the patient or remote monitor to takeaction to raise or lower the patient's glucose level as needed.

FIG. 8C illustrates an implementation for discreetly communicating aclinically risky situation to a user by varying the background color1826 of unitary icon 1820. In the implementation of FIG. 8C, unitaryicon 1820 has a background of a gradient of colors. This gradient mayinclude multiple colors arranged in various patterns to represent thepatient's clinical risk. Illustrating the patient's clinical risk usinga gradient of colors allows a patient to quickly ascertain whetherremedial action is needed. For example, if a patient's current glycemicstate is low but rising into an in-target value, then the clinical riskto the patient may be low. Rather than display a solid red color in theunitary icon based on the patient's current glycemic state, a gradientof colors may be used to represent the predicted change in the patient'sglycemic state using, for example, a red-gray gradient. In this example,the red-gray gradient may allow a user to quickly understand thishis/her low glucose levels are rising.

In the implementation of FIG. 8C, the patient's current glycemic statemay be visually represented in the lower left side of unitary icon 1820,and the patient's extrapolated glycemic state may be visuallyrepresented in the upper right side of the unitary icon. Othervariations are possible including, for example, illustrating the currentglycemic state on the bottom or left side of unitary icon 1820, and anextrapolated glycemic state on the top or right side of the unitaryicon, and the like. Here, the patient's current glucose level is 65mg/dL, which is determined to be low. As such, the lower left side ofthe unitary icon is shaded red. Because indicator 1822 is pointingnortheast (i.e., a positive rate of change), the patient's glucose levelis likely to rise at a steady rate of change. Consequently, even thoughthe patient's glucose level is currently low, the patient's clinicalrisk may be considered low because his or her current glucose level ispredicted to rise due to the positive rate of change. Because thepatient's extrapolated glycemic state presents a low clinical risk, theupper right side of the unitary icon is shaded gray. In contrast, by wayof example, should the rate of change be decreasing, then backgroundcolor 1826 may be completely red, without any grey shading, to indicatethat the patient's current glycemic state (which is low) may continue todrop and put the patient in a high clinical risk condition.

In some implementations, the application may change the appearance ofindicator 1822 to indicate a clinically risky situation. For example,the application may enlarge indicator 1822, flash or blink theindicator, and/or change its color depending upon the level of thepatient's determined clinical risk. In an implementation, the indicator1822 may flash and/or may be a first color when it is determined thatthe user is in a high risk clinical situation, and may not flash and/ormay be a different second color when the user is determined to be in alow risk clinical situation.

FIG. 8D illustrates another mechanism for visualizing a patient'sclinical risk state using application 255. View 1910 may include twoicons 1912 and 1922. Icon 1912 displays the patient's current glucoselevel 1914 and has a background color 1916. Background color 1916indicates the patient's current glucose level, such as whether thecurrent glucose level is low, in target, or high. Icon 1922 representsthe patient's extrapolated glucose level 1924 and has a background color1926. Background color 1926 indicates whether the extrapolated glucoselevel is predicted to be low, in target, or high. Extrapolation line1918 connects unitary icons 1912 and 1922. A time indicator 1920 may bedisplayed adjacent to extrapolation line 1918 to indicate when theextrapolated glucose level is estimated to occur. In the implementationof FIG. 8D, unitary icons 1912 and 1922 do not have indicators torepresent the rate of change. Omitting these indicators may bebeneficial as it reduces the amount of information displayed to theuser. In some implementations, however, these indicators may be added tounitary icons 1912 and 1922.

The glucose monitoring application may supplement the visualizationsdescribed above with textual messages to indicate the clinical risk.These messages may include suggested actions to mitigate the risk. Forexample, when the user is at risk for becoming hypoglycemic, the messagemay prompt the patient to administer insulin, consume glucose or food,seek medical attention, and the like.

Application 225 running on hand held computing devices 18 and/or 19 maybe configured to issue alerts using alert module 275. Alerts may notifya user of glucose levels that exceed or fall below certain predeterminedthresholds, for example. Generating these alerts may prompt a patient orremote monitor to take corrective action in order to prevent injury tothe patient. Different types of alerts may be generated including, forexample, audible alerts, visual alerts, haptic alerts, message alerts(e.g., sending an e-mail to a patient or remote monitor), and acombination thereof.

Alert module 275 may generate different alerts using process 9000illustrated in FIG. 9A. At 9010, alert module 275 may receive glucoselevel data from sensor system 8. At 9020, alert module 275 may comparethe received glucose level data to various predetermined thresholds,such as glucose value threshold and/or a rate of change threshold. Forexample, if the low glucose level alert is set in alert module 275, thealert module may compare the received glucose level to a correspondingthreshold value for this alert. Based on this comparison, alert module275 may generate an alert on device 18 and/or 19 at 9030. For example,alert module 275 may generate an alert if the received glucose level isless than the threshold value. The following paragraphs describedifferent types of alerts maintained by alert module 275.

FIG. 9B illustrates a user interface 910 for managing a user's alerts.These alerts may include glucose level alerts, such as an urgent lowalert 912, a low alert 914, a high alert 916, a rise rate alert 918, anda fall rate alert 930. Glucose level alert module 276 may manage theseglucose level alerts. User interface 910 may also include alertsrelating to a communication failure, such as no data alert 932.Communication failure alert module 277 may manage no data alert 932.

Alert menu 910 may indicate whether these alerts are enabled ordisabled. For example, rise rate alert 918 may be disabled as indicatedby the word “OFF” in alert menu 910. In another example, urgent lowalert 912 may be enabled as indicated by the adjacent green label. Thisgreen label may display a number or threshold value that indicates whenthe alarm may trigger. In the implementation of FIG. 9B, urgent lowalert 912 may trigger if the glucose level falls below 55 mg/dL. Theuser may reset all alert settings to default values by selecting item934. Upon doing so, user interface 936 may appear, asking the user toconfirm the reset request. If, however, the user wishes to adjust aparticular alert's settings, he or she may do so by selecting theappropriate alert. Each of these alerts is described below with respectto FIGS. 10A, 10B, 11, 12, 13, 14, and 15.

FIGS. 10A and 10B illustrate various user interfaces for adjusting thesettings associated with the low alert. User interface 1000 may appearwhen low alert 914 is selected from alert menu 910. The user may enableor disable the low alert by adjusting slider 1010. The user may obtaininformation regarding the low alert by selecting question mark icon1005. Upon doing so, user interface 1025 may be displayed. Userinterface 1025 may be a help screen that provides a description of thelow alert. The low alert may be generated or triggered when thepatient's glucose level falls below a particular threshold. Userinterface 1000 may also display various settings associated with the lowalert. These settings may include the threshold value or trigger 1013for the alert, how often the alert should be repeated 1016, and thesound 1019 for the alert. User interface 1000 may display the currentvalues for settings 1013, 1016, and 1019. The user may change thesevalues by selecting the desired setting.

For example, if the user selects item 1013 to change the thresholdvalue, then user interface 1050 may be displayed. If the user selectsitem 1016 to change the alert's repeat settings, then user interface1055 may be displayed. Likewise, if the user selects item 1019 to changethe sound associated with the alert, then user interface 1060 may bedisplayed. The user may select a sound from a predetermined list ofsounds. Designating different sounds for different alerts may allow auser to distinguish the alerts from each other. The user may use thescrolling keypads on interfaces 1050, 1055 and 1060 to select thedesired values for settings 1013, 1016, and 1019, respectively.

FIG. 11 illustrates user interfaces 1100 and 1125 associated with theurgent low alert. User interface 1100 may appear when urgent low alert912 is selected from alert menu 910. The user may obtain informationregarding the urgent low alert by selecting question mark icon 1105.Upon doing so, user interface 1125 may be displayed. User interface 1125may be a help screen that provides a description of the urgent lowalert. The urgent low alert may be generated or triggered when thepatient's glucose level falls below a predetermined threshold. In someimplementations, this predetermined threshold may not be adjusted, andthis alert may not be disabled. User interface 1100 may also displayvarious settings associated with the urgent low alert. These settingsmay include the threshold value or trigger 1113 for the alert, how oftenthe alert should be repeated 1116, and the sound 1119 for the alert. Thevalues associated with settings 1113, 1116, and 1119 may be adjustedusing interfaces similar to those illustrated in FIG. 10B.

FIG. 12 illustrates user interfaces 1200 and 1225 associated with thehigh alert. User interface 1200 may appear when high alert 916 isselected from alert menu 910. The user may enable or disable the highalert by adjusting slider 1210. The user may obtain informationregarding the high alert by selecting question mark icon 1205. Upondoing so, user interface 1225 may be displayed. User interface 1225 maybe a help screen that provides a description of the high alert. The highalert may be generated or triggered when the patient's glucose levelreadings increase above a certain threshold. User interface 1200 mayalso display various settings associated with the high alert. Thesesettings may include the threshold value or trigger 1213 for the alert,how often the alert should be repeated 1216, and the sound 1219 for thealert. The values associated with settings 1213, 1216, and 1219 may beadjusted using interfaces similar to those illustrated in FIG. 10B.

FIG. 13 illustrates user interfaces 1300 and 1325 associated with therise rate alert. User interface 1300 may appear when rise rate alert 918is selected from alert menu 910. The user may enable or disable the riserate alert by adjusting slider 1310. The user may obtain informationregarding the rise rate alert by selecting question mark icon 1305. Upondoing so, user interface 1325 may be displayed. User interface 1325 maybe a help screen that provides a description of the rise rate alert. Therise rate alert may be generated or triggered when the patient's glucoselevels rise too quickly relative to a particular threshold. Userinterface 1300 may also display various settings associated with therise rate alert. These settings may include the threshold value ortrigger 1313 for the alert, how often the alert should be repeated 1316,and the sound 1319 for the alert. The values associated with settings1313, 1316, and 1319 may be adjusted using interfaces similar to thoseillustrated in FIG. 10B.

FIG. 14 illustrates user interfaces 1400 and 1425 associated with thefall rate alert. User interface 1400 may appear when fall rate alert 930is selected from alert menu 910. The user may enable or disable the fallrate alert by adjusting slider 1410. The user may obtain informationregarding the fall rate alert by selecting question mark icon 1405. Upondoing so, user interface 1425 may be displayed. User interface 1425 maybe a help screen that provides a description of the fall rate alert. Thefall rate alert may be generated or triggered when the patient's glucoselevels fall too quickly relative to a particular threshold. Userinterface 1400 may also display various settings associated with thefall rate alert. These settings may include the threshold value ortrigger 1413 for the alert, how often the alert should be repeated 1416,and the sound 1419 for the alert. The values associated with settings1413, 1416, and 1419 may be adjusted using interfaces similar to thoseillustrated in FIG. 10B.

FIG. 15 illustrates user interfaces 1500 and 1525 associated with the nodata alert. User interface 1500 may be a help screen that provides adescription of the no data alert. Communication failure alert module 277may generate the no data alert when the application stops receivingglucose readings from sensor system 8 after a predetermined period oftime. The user may adjust the value of this predetermined time using thescrolling keypad of user interface 1525.

Alert module 275 may generate an alert to advise a user that aparticular threshold condition or level has been met. Because theapplication may be running on different hand held computing devices 18and 19 that may be multi-use devices (i.e., not dedicated glucosemonitoring devices), potentially with different operating platforms,these alerts may be tailored to operate within the constraints of eachcomputing device. For example, the ring or alert volume in a smartphone's settings may determine the volume of an alert. If, for example,the mute switch is enabled on the phone, then application 255 may beunable to generate audible alerts. In another example, a user may setvarious notification settings in his or her phone. These settings mayaffect the manner in which alerts are displayed. Various factors mayaffect this process including, for example, whether the phone is lockedor unlocked, whether the application is currently being used or idlingin the background, and the like. The phone may be in a locked statewhen, for example, the user is unable to interact with applicationsrunning on the phone. While in a locked state, the user may be able toenter a passcode to bring the phone into an unlocked state. When thephone is in an unlocked state, a user may be able to interact withapplications running on the phone. The following implementationsdisclose various solutions to these design constraints.

FIGS. 16A, 16B, and 16C illustrate a mechanism for alerting a user whenhis or her hand held computing device 18 and/or 19 is locked. Althoughthe implementation of FIGS. 16A, 16B, and 16C is described with respectto a rise rate alert, this implementation may apply to any alertdiscussed herein.

FIG. 16A illustrates an interface 1510 that displays a rise rate alert1512 on a locked screen. Glucose level alert module 276 may generatealert 1512 when the user has enabled the alert and when the thresholdlevel has been reached as described above with respect to process 9000of FIG. 9A. Alert 1512 may include text indicating the type of alertthat has been generated or triggered, an icon or graphicalrepresentation of the alert, and the like. In the implementation of FIG.16A, the alert does not display any numerical values associated with thealert (e.g., how quickly the patient's glucose level is rising and howlong it has exceeded the threshold level). Omitting this information canallow a user to view his or her alerts discreetly in public withoutcalling undue attention to himself or herself. Omitting this informationcan also prevent the presentation of stale data and encourage the userto launch the application in order to obtain more detailed information.For example, if alert 1512 displayed a patient's current glycemic stateon device 18 and the device loses connectivity with sensor system 8, thepatient may think that his/her current glycemic state is stable when, infact, application 255 is unable to update this value. This situation maybe especially dangerous if, for example, alert 1512 provides a numericalvalue indicating that the patient's current glycemic level is in-targetbut has actually dropped below lower threshold value 332 since thepatient's phone 18 has lost connectivity with sensor system 8. Whetherthese numerical values and/or a representation of the rate of change aredisplayed may be configured by a user using alert module 275 and/orglucose level alert module 276 in some implementations.

Alert 1512 may display instructions for viewing additional informationregarding the alert. In the instant implementation, the alert mayinstruct the user to “slide to view.” Glucose alert module 276 maydisplay user interface 1514 of FIG. 16B after the user has followedthese instructions.

User interface 1514 may provide details regarding the nature of thealert. The details that are displayed may depend on the alert that isgenerated. For example, when the alert is related to the status of thesystem, the alert may provide information regarding the alert condition.For example, if no data alert 932 is generated, then user interface 1514may display the duration of time since application 255 last receivedglucose level data from sensor system 8. In another example, if acalibration measurement is needed, then user interface 1514 may displaya textual message indicating the same.

When the alert is related to the patient's glucose level, user interface1514 may display, for example, the patient's current glucose level, thethreshold value associated with the alert, and the like. User interface1514 may specify the alert type 1516 and display a unitary icon 1520 forglucose level alerts. Unitary icon may display the patient's currentglucose level 1524. The background color 1526 may indicate that thisglucose level is in target. However, because indicator 1522 has twoarrow indicators, the rate of change of this glucose level is rapidlyincreasing. Under these circumstances, the patient may becomehyperglycemic if no action is taken. User interface 1514 may prompt theuser to acknowledge this alert by selecting item 1541. If the user doesnot acknowledge the alert, the application may continue to re-alertuntil acknowledgement has been received or until the condition thattriggered the alert is no longer satisfied. The application may re-alertat predetermined intervals (e.g., every 5 minutes) until the useracknowledges the alert. Continuing to re-alert may help ensure that auser sees the alert, particularly if application 255 is idling in thebackground.

Once the user acknowledges the alert, glucose alert module 276 mayactivate or launch the application and display user interface 1540illustrated in FIG. 16C. User interface 1540 may be the home screen andprovide detailed information regarding the patient's glucose levels.Like user interface 1514, this interface may include unitary icon 1520and indicator 1522. In addition, this interface may also display a trendgraph 1530 of the patient's glucose levels.

The implementation of FIGS. 16A, 16B, and 16C may be varied depending onthe state of the hand held computing device and/or the state of theapplication. If, for example, the hand held computing device is unlockedand the application is active (i.e., currently being used), then alertsmay be displayed within the application as notifications. If, however,the hand held computing device is unlocked and the application is idlingin the background, then alerts may be displayed as banners. Thesebanners may temporarily appear anywhere within the computing device'sdisplay screen (e.g., near the top) and vanish after a predeterminedperiod of time (e.g., 5 seconds). If a user slides his or her fingerover the banner alert, alert module 264 may display user interface 1514of FIG. 16B, for example. If the mute switch on the device is enabled,then the application may generate various non-audible alerts including,for example, a vibrating alert or visualization. The visualization mayinclude, for example, a flashing screen, a shaded screen, and the likeas described above with respect to FIGS. 8A and 8B. If alerts may not beaudibly generated on the patient's hand held computing device, anotherdevice, such as receiver 16 of FIG. 1, may generate these alerts. Theapplication may re-generate these notifications, banners, vibratingalerts, and visualizations until the alert is acknowledged or until thecondition that triggered the alert is no longer satisfied. Anotification center on the hand held computing device may maintain a logof these alerts. This log may specify, for example, the type of alert,when the alert was triggered, how many times it was re-generated, andthe like. The notification center may remove an alert after it has beenacknowledged. A user may view old alerts from a history view in theapplication.

In some implementations, alert settings may be modified based on thetime of day. If for, example, a patient is asleep at night between 10 PMand 6 AM, he or she may be less likely to be aware of his or herglycemic state and/or to hear or respond to alerts. In order to accountfor the patient's decreased awareness and responsiveness during thesehours, the application may enter a night mode by automaticallytightening the glucose threshold levels for various alerts. Adjustingthese threshold levels may account for a reduced responsiveness in apatient as he or she may be sleeping. These adjustments may, in turn,allow more time for the patient or a remote monitor to take correctiveaction before the patient experiences serious injury.

For example, if the low alert is normally triggered when the patient'sglucose level drops below 60 mg/dL, then the night mode threshold may be80 mg/dL. Increasing the threshold level for the low alert may allow theapplication to generate this alert earlier or more frequently. Inanother example, if the high alert is normally triggered when thepatient's glucose level rises above 180 mg/dL, then the night modethreshold may be 190 mg/dL, so as to avoid disturbing the patient'ssleep. Increasing the threshold level for the high alert may allow theapplication to generate this alert less frequently. FIG. 17 illustratesa user interface 1850 that describes night mode operation. A user maydesignate night mode hours and select which alerts are subject to nightmode adjustments. If night mode is disabled, the alerts may be activeall day. In some implementations, only low alerts may be activatedduring night mode operation and high alerts may be deactivated because ahypoglycemic state is more dangerous than a hyperglycemic state.

In implementations where an insulin pump is attached to the patient, theinsulin pump may have a different insulin delivery profile during nightmode hours. In some implementations, night mode alerts may havedifferent alert sounds, volume, and repeat frequencies than non-nightmode alerts. For example, the application may use high volume jarringsounds for alarms in order to wake the user during night mode hours.

As described above, the state of a user's hand held computing device mayaffect alert generation. If, for example, the hand held computing deviceis in a muted state, then a user may be unable to hear audible alerts.This may be problematic if, for example, the user accidentally mutes hisor her hand held computing device. FIG. 18 illustrates a process 1907for issuing an alert when computing device 18 is muted or otherwiseunable to generate audible alerts.

At 1910, mute mode alert module 278 may determine whether the mute modeon computing device 18 has been enabled or if audible alerts fromapplication 255 are suppressed. If so, mute mode alert module 278 mayperform one or more of processes 1920, 1930, and 1940. These processesmay be performed sequentially or substantially simultaneously.

At 1920, mute mode alert module 278 may notify the user that the mutemode has been enabled on computing device 18. In some implementations,mute mode alert module 278 may display graphical user interface 1905illustrated in FIG. 19 to educate the user of the drawbacks of mutinghis or her computing device. User interface 1905 may indicate thatsounds will not be played. Mute mode alert module 278 may display userinterface 1905 when the user sets up alerts using alert menu 910 or whenthe application detects that the computing device is in a muted state.Mute mode alert module 278 may additionally generate a vibratory alertto catch the user's attention. In order to close user interface 1905 andto stop these vibrations, the user may be required to acknowledge themessage. In some implementations, the mute mode alert module 278 maysend a text message or email message to the user to indicate that thecomputing device has been muted. Additionally or alternatively, the mutemode alert module 278 may cause the computing device to send a messageregarding the patient's muted device to a server, such as server 230.The server may, in turn, inform various remote monitors 19, such asfamily members, physicians, and the like.

In addition to informing remote monitors that the patient's device ismuted, the mute mode alert module 278 may also inform remote monitorsthat an alert has been triggered at the patient's computing device andthat the mute mode is enabled at the patient's computing device. Forexample, if the patient's low alert threshold level is satisfied, themute mode alert module 278 may send a message to server 230 indicatingthe same. Server 230 may, in turn, relay the message to the remotemonitors. These messages may be sent as a text message, a phone call, ane-mail, an audible sound, and the like at the remote monitors' devices19. In order to reduce over alerting, the server 230 may relay thesealerts if the patient has failed to acknowledge the alert on his or hercomputing device 18.

At 1930, the mute mode alert module 278 may work with other componentsin the system to generate alerts when the patient's computing device 18is muted. For example, the mute mode alert module 278 on the patient'scomputing device 18 may cause receiver 16 to display the alert if thepatient has failed to acknowledge the alert after a predetermined amountof time (e.g., 15 minutes). Under these circumstances, receiver 16 maybecome the primary alert device. When this occurs, receiver 16 maygenerate local audio and visual alarms and send messages regarding thesame to the patient's remote monitors. In some implementations, receiver16 may work with sensor system 8 to issue these local alarms andmessages. If, for example, sensor system 8 detects that the patient'scomputing device is muted and that the user has not acknowledged anyalerts, the sensor system may trigger an alert on receiver 16.

The severity of the alert may also alter the way in which the systemresponds at 1940. As described above, when the mute switch is firstengaged on the patient's computing device 18, a warning alert may bevisually presented. If the patient fails to acknowledge this warning andthe patient progresses into a low/high risk state or becomeshypoglycemic/hyperglycemic for a predetermined time period, the system(e.g., mute mode alert module 278 on the patient's computing device, thereceiver, and/or a remote monitor who receives a message through aserver) may automatically alert medical personnel, such as an emergencyresponder. In some implementations, mute mode alert module 278 may alsotighten alert threshold levels when the patient's computing device ismuted. This tightening of threshold levels may be similar to thetightening of threshold levels described above with respect to nightmode operation. Tightening threshold levels may cause alerts to triggersooner and/or more frequently which, in turn, may provide the patientmore time to react. The adjustments described above may be activatedduring different hours of the day. For example, because the effects ofhypoglycemia are less likely to be felt while the patient is asleep, theoption of contacting medical personnel may only be enabled at nighttimehours.

The activation of the mute switch on the patient's computing device 18may also trigger the modification of other processes at 1940, such asthe dosing of insulin. These adjustments may be helpful inimplementations where the patient's computing device is in communicationwith an insulin pump. If, for example, mute mode alert module 278detects that the mute switch is enabled, the application may suspend theactivities of the insulin pump.

Process 1907 may be applied in any situation when audio alerts may notbe heard on a patient's computing device 18. As such, process 1907 isnot limited to scenarios when the patient's computing device 18 ismuted. Process 1907 may also apply when headphones or earphones areinserted into the patient's computing device 18, when anotherapplication running on the device suppresses sounds from otherapplications, and the like.

Alert module 275 may check alert conditions so long as application 255is running. In some circumstances, however, application 255 may stoprunning or functioning. This may occur if, for example, the patient'scomputing device 18 terminates application 255 due to competingresources, if the computing device 18 is turned off, if the useraccidentally or intentionally terminates application 255, if application255 and computing device 18 lack sufficient connectivity to receiveglucose data from receiver 16 or issue alerts, and the like. Process2007 as illustrated in FIG. 20 describes various mechanisms for alertinga user that application 255 has stopped running.

At 2010, communication failure alert module 277 may determine whetherapplication 255 is running. If application 255 has stopped running orstopped functioning for any of the reasons described above,communication failure alert module 277 and/or computing device 18 mayperform one or more of processes 2020, 2030, 2040, and 2050. Theseprocesses may be performed sequentially or substantially simultaneously.

At 2020, communication failure alert module 277 may use functionslocally available on the patient's computing device 18, such as a localcalendar application or alarm function, to warn a user that application255 has stopped running. In these implementations, communication failurealert module 277 may schedule an alarm to trigger at a predeterminedtime, such as a half hour from the current time. Communication failurealert module 277 may continuously push this alarm out at fixed timeintervals (e.g., every 15 minutes) to reschedule the alarm.Communication failure alert module 277 may be unable to reschedule thealarm, however, if application 255 is terminated. When this occurs, thelocal alarm may eventually trigger and sound off. The computing device18 may display a notification indicating that application 255 is nolonger working to accompany the local alarm.

In some circumstances, application 255 may have scheduled downtime. Thismay occur, for example, during a software upgrade or routinemaintenance. At 2030, communication failure alert module 277 may issue awarning on computing device 18 and/or 19 to indicate that application255 is scheduled to terminate. This warning may prompt the patient andhis or her remote monitors to ensure that other alerting devices areavailable to generate alerts during this downtime.

In some circumstances, an event at computing device 18 may causeapplication 255 to stop running. These events may require the user torestart computing device 18 which, in turn, may stop application 255.These events may be, for example, an operating system upgrade and thelike. If the glucose monitoring application is aware of these scheduledrestarts, then communication failure alert module 277 may notify usersahead of time that application 255 will stop functioning.

At 2040, computing device 18 may receive a notification from a serverthat application 255 is not working. The server may expect acommunication from application 255 at predetermined intervals (e.g.,every 5 minutes). If the server does not receive the expectedcommunication from application 255, it may send a notification, such asan e-mail or a text message, to computing device 18 and/or 19 toindicate that application 255 is not working. Upon receiving thisnotification, computing device 18 and/or 19 may notify communicationfailure alert module 277 of the same and restart application 255.

At 2050, computing device 18 may perform a Bluetooth® restorationprocess when application 255 has stopped running A terminatedapplication 255 may be awakened via a signal from sensor system 8. Asdescribed above with respect to FIG. 2A, sensor system 8 may beconnected to computing device 18 via an intermittent wirelessconnection, such as a Bluetooth® connection. Each time sensor system 8initiates communication with hand held computing device 18, the sensorsystem may send a message to the computing device to awaken the glucosemonitoring application 255. Computing device 18 may launch application255 upon receiving this message. In some implementations, computingdevice 18 may notify communication failure alert module 277 of the same,and the module may restart application 255.

In some implementations, the application may determine whether computingdevice 18 may turn off due to insufficient battery power and alert theuser of the same. The application may make these determinations atpredetermined times. For example, if night mode operation begins at 10PM, the application may determine whether computing device 18 hassufficient battery power to last through the end of night mode and alertthe user of the same before he or she goes to sleep (i.e., just beforethe application enters night mode operation). If there is insufficientbattery power, the application may display a notification to prompt theuser to charge his or her computing device 18.

In some implementations, the application may provide in-application helpto users. The application may detect if a user needs assistance if, forexample, the user is spending a lot of time on a particular screen,flipping between screens, missing alerts, and the like. When thisbehavior is detected, the application may display pop-up messages toguide the user through the application and/or educate the user on howthe system works.

To illustrate, in some implementations, application 255 may detect userinteraction with the application that indicates that the user is havingdifficulty understanding how to pair devices with the continuous glucosemonitoring system. User interaction representative of such difficultiesmay occur, for example, when a user stays on a particular screen inexcess of a predetermined amount of time, the user flips between severalpredetermined screens, a combination of both, and the like. Application255 may automatically generate a pop-up help message relate to thedetected behavior. Continuing with the above example, the pop-up mayprovide instructions on device pairing.

In-application help may also include user help functions that educatethe user on how alerts work. In one implementation, application 255 candetect if a user has acknowledged an alert using predetermined criteria,such as user acknowledgement of the alert within a predetermined amountof time. If the user does not acknowledge the alert within thepredetermined amount of time, then the next time the user is interactingwith application 255, the application can display a pop-up messageindicating that the user did not acknowledge the previous alert. Thepop-up message can also provide textual guidance as to why the user maynot have acknowledged the alert and how the user can configure the alertso that the user is more likely to hear the alert the next time it istriggered. For example, if a mute switch is enabled when a low alerttriggered, and a user fails to acknowledge the alert within apredetermined amount of time, application 255 may display a pop-upmessage informing the user that he/she did not acknowledge the low alertand that he/she should disable the mute switch to hear the alert thenext time it is triggered.

In addition, application 255 can log the amount of time it takes theuser to acknowledge each triggered alert. This log can later be used tomodify the user's alert settings to increase the likelihood that theuser receives alerts in a timely fashion. This modification can beperformed automatically by the application, or the application cansuggest modifications to the user, via pop-up message for example, andthe user can accept or reject the modifications. Accepting themodification would automatically modify the alert settings in theapplication as suggested by the application.

Various implementations of the subject matter described herein may berealized in digital electronic circuitry, integrated circuitry,specially designed ASICs (application specific integrated circuits),computer hardware, firmware, software, and/or combinations thereof. Thecircuitry may be affixed to a printed circuit board (PCB), or the like,and may take a variety of forms, as noted. These various implementationsmay include implementation in one or more computer programs that areexecutable and/or interpretable on a programmable system including atleast one programmable processor, which may be special or generalpurpose, coupled to receive data and instructions from, and to transmitdata and instructions to, a storage system, at least one input device,and at least one output device.

These computer programs (also known as programs, software, softwareapplications, or code) include machine instructions for a programmableprocessor, and may be implemented in a high-level procedural and/orobject-oriented programming language, and/or in assembly/machinelanguage. As used herein, the term “machine-readable medium” refers toany non-transitory computer program product, apparatus and/or device(e.g., magnetic discs, optical disks, memory, Programmable Logic Devices(PLDs)) used to provide machine instructions and/or data to aprogrammable processor, including a machine-readable medium thatreceives machine instructions.

To provide for interaction with a user, the subject matter describedherein may be implemented on a computer having a display device (e.g., aCRT (cathode ray tube) or LCD (liquid crystal display) monitor) fordisplaying information to the user and a keyboard and a pointing device(e.g., a mouse or a trackball) by which the user may provide input tothe computer. Other kinds of devices may be used to provide forinteraction with a user as well; for example, feedback provided to theuser may be any form of sensory feedback (e.g., visual feedback, audiblefeedback, or tactile feedback); and input from the user may be receivedin any form, including acoustic, speech, or tactile input.

The subject matter described herein may be implemented in a computingsystem that includes a back-end component (e.g., as a data server), orthat includes a middleware component (e.g., an application server), orthat includes a front-end component (e.g., a client computer having agraphical user interface or a Web browser through which a user mayinteract with an implementation of the subject matter described herein),or any combination of such back-end, middleware, or front-endcomponents. The components of the system may be interconnected by anyform or medium of digital data communication (e.g., a communicationnetwork). Examples of communication networks include a local areanetwork (“LAN”), a wide area network (“WAN”), and the Internet.

Although a few variations have been described in detail above, othermodifications are possible. For example, while the descriptions ofspecific implementations of the current subject matter discuss analyticapplications, the current subject matter is applicable to other types ofsoftware and data services access as well. Moreover, although the abovedescription refers to specific products, other products may be used aswell. In addition, the logic flows depicted in the accompanying figuresand described herein do not require the particular order shown, orsequential order, to achieve desirable results. Other implementationsmay be within the scope of the following claims.

The above description presents the best mode contemplated for carryingout the present invention, and of the manner and process of making andusing it, in such full, clear, concise, and exact terms as to enable anyperson skilled in the art to which it pertains to make and use thisinvention. This invention is, however, susceptible to modifications andalternate constructions from that discussed above that are fullyequivalent. Consequently, this invention is not limited to theparticular embodiments disclosed. On the contrary, this invention coversall modifications and alternate constructions coming within the spiritand scope of the invention as generally expressed by the followingclaims, which particularly point out and distinctly claim the subjectmatter of the invention. While the disclosure has been illustrated anddescribed in detail in the drawings and foregoing description, suchillustration and description are to be considered illustrative orexemplary and not restrictive.

All references cited herein are incorporated herein by reference intheir entirety. To the extent publications and patents or patentapplications incorporated by reference contradict the disclosurecontained in the specification, the specification is intended tosupersede and/or take precedence over any such contradictory material.

Unless otherwise defined, all terms (including technical and scientificterms) are to be given their ordinary and customary meaning to a personof ordinary skill in the art, and are not to be limited to a special orcustomized meaning unless expressly so defined herein. It should benoted that the use of particular terminology when describing certainfeatures or aspects of the disclosure should not be taken to imply thatthe terminology is being re-defined herein to be restricted to includeany specific characteristics of the features or aspects of thedisclosure with which that terminology is associated. Terms and phrasesused in this application, and variations thereof, especially in theappended claims, unless otherwise expressly stated, should be construedas open ended as opposed to limiting. As examples of the foregoing, theterm ‘including’ should be read to mean ‘including, without limitation,’‘including but not limited to,’ or the like; the term ‘comprising’ asused herein is synonymous with ‘including,’ ‘containing,’ or‘characterized by,’ and is inclusive or open-ended and does not excludeadditional, unrecited elements or method steps; the term ‘having’ shouldbe interpreted as ‘having at least;’ the term ‘includes’ should beinterpreted as ‘includes but is not limited to;’ the term ‘example’ isused to provide exemplary instances of the item in discussion, not anexhaustive or limiting list thereof; adjectives such as ‘known’,‘normal’, ‘standard’, and terms of similar meaning should not beconstrued as limiting the item described to a given time period or to anitem available as of a given time, but instead should be read toencompass known, normal, or standard technologies that may be availableor known now or at any time in the future; and use of terms like‘preferably,’ ‘preferred,’ ‘desired,’ or ‘desirable,’ and words ofsimilar meaning should not be understood as implying that certainfeatures are critical, essential, or even important to the structure orfunction of the invention, but instead as merely intended to highlightalternative or additional features that may or may not be utilized in aparticular embodiment of the invention. Likewise, a group of itemslinked with the conjunction ‘and’ should not be read as requiring thateach and every one of those items be present in the grouping, but rathershould be read as ‘and/or’ unless expressly stated otherwise. Similarly,a group of items linked with the conjunction ‘or’ should not be read asrequiring mutual exclusivity among that group, but rather should be readas ‘and/or’ unless expressly stated otherwise.

Where a range of values is provided, it is understood that the upper andlower limit, and each intervening value between the upper and lowerlimit of the range is encompassed within the embodiments.

With respect to the use of substantially any plural and/or singularterms herein, those having skill in the art can translate from theplural to the singular and/or from the singular to the plural as isappropriate to the context and/or application. The varioussingular/plural permutations may be expressly set forth herein for sakeof clarity. The indefinite article ‘a’ or ‘an’ does not exclude aplurality. A single processor or other unit may fulfill the functions ofseveral items recited in the claims. The mere fact that certain measuresare recited in mutually different dependent claims does not indicatethat a combination of these measures cannot be used to advantage. Anyreference signs in the claims should not be construed as limiting thescope.

It will be further understood by those within the art that if a specificnumber of an introduced claim recitation is intended, such an intentwill be explicitly recited in the claim, and in the absence of suchrecitation no such intent is present. For example, as an aid tounderstanding, the following appended claims may contain usage of theintroductory phrases ‘at least one’ and ‘one or more’ to introduce claimrecitations. However, the use of such phrases should not be construed toimply that the introduction of a claim recitation by the indefinitearticles ‘a’ or ‘an’ limits any particular claim containing suchintroduced claim recitation to embodiments containing only one suchrecitation, even when the same claim includes the introductory phrases‘one or more’ or ‘at least one’ and indefinite articles such as ‘a’ or‘an’ (e.g., ‘a’ and/or ‘an’ should typically be interpreted to mean ‘atleast one’ or ‘one or more’); the same holds true for the use ofdefinite articles used to introduce claim recitations. In addition, evenif a specific number of an introduced claim recitation is explicitlyrecited, those skilled in the art will recognize that such recitationshould typically be interpreted to mean at least the recited number(e.g., the bare recitation of ‘two recitations,’ without othermodifiers, typically means at least two recitations, or two or morerecitations). Furthermore, in those instances where a conventionanalogous to ‘at least one of A, B, and C, etc.’ is used, in generalsuch a construction is intended in the sense one having skill in the artwould understand the convention (e.g., ‘a system having at least one ofA, B, and C’ would include but not be limited to systems that have Aalone, B alone, C alone, A and B together, A and C together, B and Ctogether, and/or A, B, and C together, etc.). In those instances where aconvention analogous to ‘at least one of A, B, or C, etc.’ is used, ingeneral such a construction is intended in the sense one having skill inthe art would understand the convention (e.g., ‘a system having at leastone of A, B, or C’ would include but not be limited to systems that haveA alone, B alone, C alone, A and B together, A and C together, B and Ctogether, and/or A, B, and C together, etc.). It will be furtherunderstood by those within the art that virtually any disjunctive wordand/or phrase presenting two or more alternative terms, whether in thedescription, claims, or drawings, should be understood to contemplatethe possibilities of including one of the terms, either of the terms, orboth terms. For example, the phrase ‘A or B’ will be understood toinclude the possibilities of ‘A’ or ‘B’ or ‘A and B.’

All numbers expressing quantities of ingredients, reaction conditions,and so forth used in the specification are to be understood as beingmodified in all instances by the term ‘about.’ Accordingly, unlessindicated to the contrary, the numerical parameters set forth herein areapproximations that may vary depending upon the desired propertiessought to be obtained. At the very least, and not as an attempt to limitthe application of the doctrine of equivalents to the scope of anyclaims in any application claiming priority to the present application,each numerical parameter should be construed in light of the number ofsignificant digits and ordinary rounding approaches.

Furthermore, although the foregoing has been described in some detail byway of illustrations and examples for purposes of clarity andunderstanding, it is apparent to those skilled in the art that certainchanges and modifications may be practiced. Therefore, the descriptionand examples should not be construed as limiting the scope of theinvention to the specific embodiments and examples described herein, butrather to also cover all modification and alternatives coming with thetrue scope and spirit of the invention.

What is claimed is:
 1. A method comprising: executing, by at least oneprocessor, an application to generate one or more alerts on a devicerelating to a glucose level of a patient, the executing comprising:accessing, by at least one processor, a current glucose level of apatient; accessing, by at least one processor, one or more conditionsassociated with the one or more alerts, the one or more conditionsdefining a relationship between the current glucose level and one ormore threshold values; determining, by at least one processor, whetherthe one or more conditions are satisfied; and generating, by at leastone processor, the one or more alerts when the one or more conditionsare satisfied, the one or more alerts that are generated based on one ormore of a state of the device and a state of the application.
 2. Themethod of claim 1, wherein the state of the device is one or more of alocked state, an unlocked state, a muted stated, and an unmuted state,and wherein the state of the application is an active state or aninactive state.
 3. The method of claim 2, wherein the application is inan active state when the application is displayed on a foreground of ascreen of the device, and wherein the application is in an inactivestate when the application is displayed on a background of the screen ofthe device.
 4. The method of claim 2, wherein the one or more alertscomprise one or more non-audible alerts when the device is in a mutedstate, and wherein the one or more non-audible alerts comprise one ormore of a vibration or a visualization displayed on a screen of thedevice, the visualization comprising a flashing screen or a shadedscreen.
 5. The method of claim 2, wherein the one or more alertscomprise one or more local notifications displayed on a locked screen ofthe device when the device is in a locked state, and wherein the one ormore local notifications display an identifier associated with the oneor more alerts.
 6. The method of claim 5, wherein the one or more localnotifications further display the current glucose level and a trendarrow representative of a rate of change of the current glucose level.7. The method of claim 2, wherein the one or more alerts comprise one ormore banners when the device is in an unlocked state and the applicationis in an inactive state, and wherein the one or more banners display anidentifier associated with the one or more alerts for a predeterminedperiod of time on a screen of the device.
 8. The method of claim 7,wherein the one or more alerts further comprise one or more audiblealerts.
 9. The method of claim 1, further comprising: re-generating, byat least one processor, the one or more alerts at a predeterminedfrequency until an acknowledgment of the one or more alerts is receivedor when the one or more conditions are no longer satisfied.
 10. Themethod of claim 1, wherein the one or more alerts comprise an urgent lowalert, a low alert, a high alert, a rise rate alert, a fall rate alert,or a no data alert.
 11. The method of claim 10, wherein the urgent lowalert is not modifiable.
 12. The method of claim 1, further comprising:adjusting, by at least one processor, the one or more threshold valuesassociated with the one or more alerts during a predetermined period oftime, the adjusting causing the one or more conditions of one or morealerts to be satisfied more frequently than without the adjusting. 13.The method of claim 12, wherein the adjusting is performed during anight mode.
 14. A system comprising: a processor; and a memory, whereinthe processor and the memory are configured to perform operationscomprising: executing an application to generate one or more alerts on adevice relating to a glucose level of a patient, the executingcomprising: accessing a current glucose level of a patient; accessingone or more conditions associated with the one or more alerts, the oneor more conditions defining a relationship between the current glucoselevel and one or more threshold values; determining whether the one ormore conditions are satisfied; and generating the one or more alertswhen the one or more conditions are satisfied, the one or more alertsthat are generated based on one or more of a state of the device and astate of the application.
 15. The system of claim 14, wherein the stateof the device is one or more of a locked state, an unlocked state, amuted stated, and an unmuted state, and wherein the state of theapplication is an active state or an inactive state.
 16. The system ofclaim 15, wherein the application is in an active state when theapplication is displayed on a foreground of a screen of the device, andwherein the application is in an inactive state when the application isdisplayed on a background of the screen of the device.
 17. The system ofclaim 15, wherein the one or more alerts comprise one or morenon-audible alerts when the device is in a muted state, and wherein theone or more non-audible alerts comprise one or more of a vibration or avisualization displayed on a screen of the device, the visualizationcomprising a flashing screen or a shaded screen.
 18. The system of claim15, wherein the one or more alerts comprise one or more localnotifications displayed on a locked screen of the device when the deviceis in a locked state, and wherein the one or more local notificationsdisplay an identifier associated with the one or more alerts.
 19. Thesystem of claim 18, wherein the one or more local notifications furtherdisplay the current glucose level and a trend arrow representative of arate of change of the current glucose level.
 20. The system of claim 15,wherein the one or more alerts comprise one or more banners when thedevice is in an unlocked state and the application is in an inactivestate, and wherein the one or more banners display an identifierassociated with the one or more alerts for a predetermined period oftime on a screen of the device.
 21. The system of claim 20, wherein theone or more alerts further comprise one or more audible alerts.
 22. Thesystem of claim 14, the operations further comprising: re-generating theone or more alerts at a predetermined frequency until an acknowledgmentof the one or more alerts is received or when the one or more conditionsare no longer satisfied.
 23. The system of claim 14, wherein the one ormore alerts comprise an urgent low alert, a low alert, a high alert, arise rate alert, a fall rate alert, or a no data alert.
 24. The systemof claim 23, wherein the urgent low alert is not modifiable.
 25. Thesystem of claim 14, the operations further comprising: adjusting the oneor more threshold values associated with the one or more alerts during apredetermined period of time, the adjusting causing the one or moreconditions of one or more alerts to be satisfied more frequently thanwithout the adjusting.